仪器研究方法在诊断复杂型肝脏恶性肿瘤中的预后价值

S. M. Ahmadzoda, B. D. Safarov, D. M. Kurbonov, A. S. Saidmurodov, S. A. Nazurov
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摘要

目的确定仪器方法在诊断复杂形式的肝局灶恶性病变中的预后价值:分析治疗 112 例肝脏原发性和继发性肿瘤病变患者的经验。32例(28.5%)患者出现了危及生命的并发症,如肿瘤结节自发性破裂导致大量腹腔内出血和癌性腹膜炎。有 26 例(23.2%)患者出现了这种并发症威胁的临床和超声波征象。肿瘤结节破裂的超声(US)和CT征象包括腹腔积血、病灶异型形成和周围血肿、造影剂外渗以及病灶形成部位肝脏轮廓的局灶性不连续:大多数情况下,肿瘤结节的大小超过 8.0 厘米(65% 的患者)。有 23 例(39.6%)患者的肿瘤突出肝脏表面。有 16 例(27.5%)患者的肿瘤侵犯邻近器官和组织。12例(20.6%)患者的肝血管超声多普勒检查发现血栓部位,主要位于肝静脉系统:结论:肿瘤结节自发性破裂的预测因素可能包括:肿瘤形成的大小超过 5 厘米;肿瘤通过肝脏表面突出;肿瘤肿块造成血栓形成,导致肝内压升高;肿瘤向邻近器官和组织的肝外侵犯。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic value of instrumental research methods in the diagnosis of complicated forms of liver malignant tumors
Objective: To determine prognostic value of instrumental methods in the diagnosis of complicated forms of malignant forms of focal liver lesion.Material and methods: The experience of treating 112 patients with primary and secondary tumor lesions of the liver was analyzed. Life-threatening complications, such as spontaneous rupture of the tumor node leading to massive intraperitoneal bleeding and cancerous peritonitis, were noted in 32 (28.5%) cases. Clinical and echographic signs of the threat of this complication developing were observed in 26 (23.2%) patient. Ultrasound (US) and CT semiotics of the tumor node rupture included signs of hemoperitoneum, focal heterogeneous formation with the presence of perilesional hematoma, active extravasation of contrast medium, and focal discontinuity of the liver contour at the site of the focal formation.Results and discussion: Most often, the size of the tumor node exceeded 8.0 cm (in 65% of patients). Protrusion of the tumor through the liver surface was noted in 23 (39.6%) cases. Invasion of the tumor into adjacent organs and tissues was observed in 16 (27.5%) patients. Sites of phlebothrombosis, predominantly in the system of hepatic veins, detected by echo-Dopplerography of liver vessels, were present in 12 (20.6%) patients.Conclusion: Predictors of spontaneous rupture of the tumor node may include: size of the formation more than 5 cm; protrusion of the tumor through the liver surface; phlebothrombosis by tumor masses, leading to increased intramural pressure; extraliver invasion of the tumor into adjacent organs and tissues.
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