摘要
目的探讨肾脏肿瘤患者行开放性保留肾单位手术术后出血的影响因素及临床处理方法。方法选取该院2011年1月-2013年12月收治的151例行开放性保留肾单位手术治疗的肾部肿瘤患者为研究对象,根据患者术后是否出血将其分为出血组48例以及未出血组103例,分析影响患者术后出血的相关因素及相应的处理措施。结果与未出血组相比,出血组患者年龄较大、肿瘤直径较大、肿瘤累及肾窦、肿瘤累及集合系统比例较高、术前解剖影像分类系统（PADUA）分级较高、高血压病史比例较高、ASA评分较高。经Logistic多因素分析可知,肿瘤累及肾窦（OR：3.066,95%CI：1.021-7.298）、肿瘤累及集合系统（OR：1.984,95%CI：1.021-5.201）、PADUA分级（OR：1.587,95%CI：1.085-3.412）、Renal评分（OR：1.442,95%CI：1.112-4.112）是影响肾脏肿瘤患者术后出血的独立危险因素。48例患者行保守止血32例,行高选择性肾动脉栓塞（Transcatheter endovascular,TAE）16例,所有出血者经止血治疗后均顺利出血。结论肿瘤累及肾窦、肿瘤累及集合系统、PADUA分级是影响肾脏肿瘤患者术后出血的独立危险因素。对术后出血患者行TAE能有效提高止血效果。
[ Objective ] To investigate the bleeding factors of kidney cancer patients after open surgical and clini- cal treatment. [Methods] 151 patients with kidney cancer surgery routine open were selected as the research ob- ject from January 2011 to December 2013. The patients were divided into bleeding（n =48） and not bleeding group （n =103）. The factors affecting postoperative bleeding and corresponding measures were analyzed. [Results] The aged of bleeding groups were larger than non- bleeding group. The patients aged hemorrhage were larger than non- bleeding group. The tumor diameter of bleeding groups were larger than non- bleeding group. The rates of tumors in- volving the renal sinus tumor involving the renal sinus tumor involving were higher than non-bleeding group. The anatomical image classification system （PADUA） classification preoperative hypertension a higher proportion were higher than non-bleeding group. The ASA score were higher. The tumor involving the renal sinus （OR： 3.066, 95% CI： 1.021-7.298）, tumor involving the collection system （OR： 1.984, 95% CI： 1.021-5.201）, PADUA classification （OR： 1.587, 95%CI： 1.085-3.412）, Renal scores （OR： 1.442, 95%CI： 1.112-4.112） were independent risk factors for postoperative bleeding in patients with renal tumors. 48 patients conservatively bleeding in 32 eases, 16 cases of highly selective renal artery embolization line （TAE）, all bleeding after hemostasis smoothly bleeding. [ Conclusion ] Tumor involving the renal sinus tumor involving the collection system, PADUA classification are independent riskfactors for postoperative bleeding in patients with renal tumors. TAE for postoperative bleeding patients can improve hemostasis.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第13期65-69,共5页
China Journal of Modern Medicine
关键词
肾脏肿瘤
开放手术
术后出血
影响因素
kidney tumor
open surgery
postoperative bleeding
influencing factors
