Treatment of complications of liver cancer

Complications of liver cancer are treated as follows:

(1) Spontaneous rupture and bleeding

1) Subcapsular hemorrhage: Rest in bed quietly, limit activity, apply pressure with an abdominal band, and use hemostatic drugs.

2) Intra-abdominal bleeding: conservative treatment as above, or surgery.

(2) General first aid for gastrointestinal bleeding: actively replenish blood volume, and appropriately use Pulse Tonifier to expand blood volume.

1) Hemostatic drugs: Yunnan Baiyao 0.5-1.0g orally, 4PC/d; norepinephrine saline orally; thrombin 200-500U + saline 10ml orally; batroxobin (Glycin) intravenous or intramuscular injection 1KU, phensulfonamide (Hemostatic Min), tranexamic acid (Hemostatic Aromatic) acid, 6-aminocaproic acid, carbachol (Anlox).

2) Hz receptor antagonists that inhibit gastric acid secretion and protect gastric mucosa: cimetidine or famotidine 20-40 mg; proton pump inhibitors: omeprazole 40 mg, 2PC/d.

3) Reduce portal vein pressure: vasopressin, posterior pituitary cord, somatostatin, octreotide (Sandodecanedine) 0.1 unit intravenous injection followed by 25 μg/h intravenous drip, stamipenem 0.25 mg intravenous injection followed by 0.25 mg, continuous intravenous drip.

4) Three-chamber balloon tube: compression to stop bleeding.

5) Under gastroscopy: inject hemostatic agents and sclerosing agents.

(3) Jaundice: Local external radiotherapy can be used for those with compression of the extrahepatic bile duct.

(4) Hepatic encephalopathy

1) Eliminate various inducements, prohibit the use of morphine, pethidine (meperidine), paracetamol, chloral hydrate and fast-acting barbiturates, prevent infection, regulate gastrointestinal bleeding points and water, electrolyte and acid-base balance, avoid using large amounts of diuretics to drain ascites

2) Reduce the formation and absorption of ammonia in the intestine. Fast during coma, control protein intake to 20-40g/d, inject 2-4g/d of neomycin into the gastric tube to inhibit the formation of intestinal bacteria, inject 20-60g/d of lactulose into the gastric tube to make the intestine acidic and reduce the absorption of ammonia. Vinegar enema can also be given.

3) Clear blood ammonia: sodium glutamate or potassium glutamate or arginine.

4) Correct the imbalance of amino acid metabolism in the blood by intravenous drip of an amino acid mixture mainly composed of branched-chain amino acids plus hexavalent amino acids.