肾错构瘤破裂出血患者采用手术切除和介入栓塞治疗的效果和围术期指标观察
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摘要
目的探讨肾错构瘤破裂出血患者采用手术切除和介入栓塞治疗的临床效果和围术期指标。方法选取2012年5月至2017年5月150例肾错构瘤破裂出血患者,采用随机数法将患者随机分为观察组与对照组,每组75例。对照组患者接受手术切除治疗,观察组患者接受介入栓塞治疗。观察并比较两组患者临床疗效,围术期指标(手术时间、止痛剂使用量、住院时间、正常活动恢复时间),并发症发生情况(发烧、恶心呕吐、血尿、肝功能异常)。结果两组患者治疗总有效率、手术时间比较,差异未见统计学意义(P>0.05);观察组患者止痛剂使用量低于对照组,住院时间、正常活动恢复时间短于对照组,组间比较差异有统计学意义(P<0.05);观察组患者发烧、恶心呕吐、血尿、肝功能异常发生率均低于对照组,差异有统计学意义(P<0.05)。结论肾错构瘤破裂出血患者介入栓塞治疗可达到与手术切除治疗相当的临床效果,且能够促进患者恢复,缩短住院时间,减少止痛药的使用,并发症少。该方法具有较高的临床应用价值,值得应用推广。
Objective To investigate the clinical efficacy and perioperative indicators of surgical resection and interventional embolization in patients with rupture and hemorrhage of renal hamartoma.Methods One hundred and fifty patients renal hamartoma from May 2012 to May 2017 in our hospital were randomly divided into observation group(75 cases) and control group(75 cases).The control group received surgical resection and the observation group received interventional embolization treatment.The clinical curative effect,perioperative indicators(operation time,analgesic usage,length of hospital stay,the normal activity of recovery time) and complications(fever,nausea and vomiting,blood in the urine,liver function is abnormal) were compared.Results There was no significant difference between the two groups in total effective rate or operative time(P>0.05).The dosage of analgesics in the observation group was lower than that in the control group,and the duration of hospitalization and normal activity recovery time was shorter than that in the control group,there were significant differences between the groups(P<0.05).The incidences of fever,nausea and vomiting,hematuria and liver dysfunction in the observation group were lower than those in the control group,and there were significant differences(P<0.05).Conclusions Renal hamartoma rupture hemorrhage treated by the interventional embolization may achieve the same clinical effect surgical removal,and which can promote patients recovery,shorten hospital stay,reduce the use of painkillers,and reduce the complications.This method has high clinical value and is worthy of application.
Objective To investigate the clinical efficacy and perioperative indicators of surgical resection and interventional embolization in patients with rupture and hemorrhage of renal hamartoma.Methods One hundred and fifty patients renal hamartoma from May 2012 to May 2017 in our hospital were randomly divided into observation group(75 cases) and control group(75 cases).The control group received surgical resection and the observation group received interventional embolization treatment.The clinical curative effect,perioperative indicators(operation time,analgesic usage,length of hospital stay,the normal activity of recovery time) and complications(fever,nausea and vomiting,blood in the urine,liver function is abnormal) were compared.Results There was no significant difference between the two groups in total effective rate or operative time(P>0.05).The dosage of analgesics in the observation group was lower than that in the control group,and the duration of hospitalization and normal activity recovery time was shorter than that in the control group,there were significant differences between the groups(P<0.05).The incidences of fever,nausea and vomiting,hematuria and liver dysfunction in the observation group were lower than those in the control group,and there were significant differences(P<0.05).Conclusions Renal hamartoma rupture hemorrhage treated by the interventional embolization may achieve the same clinical effect surgical removal,and which can promote patients recovery,shorten hospital stay,reduce the use of painkillers,and reduce the complications.This method has high clinical value and is worthy of application.
引文
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[8]杨兴国,聂勇,程帆,等.多中心肾错构瘤破裂出血急诊手术与非手术治疗疗效比较(附53例报告)[J].临床泌尿外科杂志,2016,31(2):115-119.
[9]李书强,李汉忠,张玉石.结节性硬化症相关肾错构瘤自发性破裂出血临床诊治分析[J].临床泌尿外科杂志,2014,29(12):1070-1072.
[10]郑汉雄,汪曾荣,夏昕晖,等.手术切除与介入栓塞治疗肾错构瘤破裂出血的疗效比较[J].现代肿瘤医学,2015,23(22):3296-3298.DOI:10.3969/j.issn.1672-4992.2015.22.027.
[2]严亮,陈羽,张俊隆,等.肾错构瘤破裂出血的临床风险因素分析[J].广东医学,2015,36(18):2822-2825.
[3]程树林,唐硕,朱平宇,等.肾错构瘤自发破裂出血的16例诊治分析[J].四川医学,2012,33(8):1354-1356.DOI:10.3969/j.issn.1004-0501.2012.08.014.
[4]邢力永,刘利维,刘春雨,等.超选择肾动脉栓塞术治疗肾错构瘤破裂出血的疗效观察[J].临床泌尿外科杂志,2015,30(11):1014-1016.
[5]刘雍,时玲燕,王军,等.无缺血状态下的后腹腔镜肿瘤剜除术治疗肾错构瘤[J].临床泌尿外科杂志,2012,27(1):20-22.
[6]李奋强,李立,王文辉,等.选择性肾动脉栓塞术在血管平滑肌脂肪瘤中临床应用价值[J].山西医药杂志(下半月刊),2013,42(3):305-307.DOI:10.3969/j.issn.0253-9926.2013.06.042.
[7]张全会,李宗明,韩新巍,等.超选择性肾动脉栓塞治疗解剖性独肾或孤立肾错构瘤(附16例分析)[J].实用放射学杂志,2014,30(7):1194-1196.DOI:10.3969/j.issn.1002-1671.2014.07.034.
[8]杨兴国,聂勇,程帆,等.多中心肾错构瘤破裂出血急诊手术与非手术治疗疗效比较(附53例报告)[J].临床泌尿外科杂志,2016,31(2):115-119.
[9]李书强,李汉忠,张玉石.结节性硬化症相关肾错构瘤自发性破裂出血临床诊治分析[J].临床泌尿外科杂志,2014,29(12):1070-1072.
[10]郑汉雄,汪曾荣,夏昕晖,等.手术切除与介入栓塞治疗肾错构瘤破裂出血的疗效比较[J].现代肿瘤医学,2015,23(22):3296-3298.DOI:10.3969/j.issn.1672-4992.2015.22.027.