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肝细胞癌(HCC)病人出现黄疸时,除了由于肿瘤压迫胆管、侵犯第一肝门或肝实质破坏外,尚应考虑到肿瘤侵入胆管。由于要兼顾治疗HCC和处理阻塞性黄疸,故治疗上较困难,我院收治HCC侵入胆管20例。报告如下。 1 临床资料 1.1 一般资料我院从1984年7月至1995年12月收治HCC1825例,其中肝癌组织侵犯胆管导致梗阻性黄疸20例(占1.09%);男18例,女2例;年龄20～69岁,平均42岁。 1.2 临床表现和实验室检查 20例病人均出现HCC与梗阻性黄疸常见的症状与特征(表1)。实验室检查的特点是血清总胆红素显著升高,碱性磷酸酶升高者占80%,乙肝表面抗原阳性和AFP≥400μg/L者各占70%和55%。丙氨酸转氨
In the case of jaundice in patients with hepatocellular carcinoma (HCC), in addition to tumor compression of the bile duct, invasion of the first porta hepatis, or destruction of the liver parenchyma, invasion of the bile duct by the tumor should be considered. Due to the need to take care of the treatment of HCC and the treatment of obstructive jaundice, it is more difficult to treat. In our hospital, 20 cases of HCC invading the bile duct were treated. The report is as follows. 1 Clinical data 1.1 General information Our hospital received HCC 1825 cases from July 1984 to December 1995. Among them, 20 cases (1.09%) of obstructive jaundice caused by invasion of the bile duct by hepatocellular carcinoma; 18 males and 2 females; 69 years old, an average of 42 years old. 1.2 Clinical manifestations and laboratory examinations 20 patients had common symptoms and features of HCC and obstructive jaundice (Table 1). Laboratory tests were characterized by a significant increase in serum total bilirubin, 80% for patients with elevated alkaline phosphatase, and 70% for hepatitis B surface antigen and 55% for AFP. Alanine transamination