[背景 ]探讨和分析肝癌自发性破裂的临床特点、合理诊治方案的制定 ,为处理此病提供借鉴和参考 .[病例报告 ]回顾性分析 45例肝癌自发性破裂出血 .全组中给 42例进行手术止血 ,3例做介入肝动脉栓塞止血 .大网膜或明胶海棉覆盖后缝扎止血 16例 ,缝扎加肝动脉结扎 10例 ,缝扎加肝动脉插管 8例 ,肝动脉结扎加无水酒精注射 4例 ,不规则肝叶切除 4例 .全组中 32例接受第二阶段综合治疗 .手术组和手术加综合治疗组的中位生存期分别为 4个月 (1～ 7个月 )和 9个月 (5～ 14个月 ) .[讨论 ]手术治疗是控制出血的有效措施 ,术后结合综合治疗可延长病人生存期 ,提高生存质量 [Background] To explore and analyze the clinical features of the spontaneous rupture of liver cancer and the development of a rational diagnosis and treatment plan, which will provide reference for the treatment of this disease. [Case report] Retrospective analysis of 45 patients with spontaneous rupture of hepatocellular carcinoma. 42 cases in the whole group Hemostasis was performed by surgery, 3 cases were involved in hepatic artery embolization to stop bleeding, 16 cases were covered by omentum or gelatin sponge, 16 cases were ligated to hepatic artery, 10 cases were sutured and hepatic artery was ligated, 8 cases were sutured and hepatic artery was cannulated, and ligation of hepatic artery was performed. Four patients received absolute ethanol injection, and 4 patients received irregular liver lobectomy. 32 patients in the whole group received comprehensive treatment at the second phase. The median survival time was 4 months for the surgery group and the combined surgery group (1 to 7). Months) and 9 months (5 to 14 months). [Discussion] Surgical treatment is an effective measure to control bleeding. Postoperative combined with comprehensive treatment can prolong patient survival and improve quality of life.