【摘要】 【目的】探讨肾血管平滑肌脂肪瘤(AML)破裂出血后不同手术时机对围手术期风险的影响。【方法】回顾性收集我院2006年1月至2016年12月间因肾血管平滑肌脂肪瘤破裂出血行肾脏手术治疗的患者,根据手术时间,将破裂出血后7 d内接受手术治疗的患者定义为近期手术组,破裂出血30 d后行手术治疗的患者定义为远期手术组。对比近期手术组和远期手术组一般资料和围手术期情况。【结果】41例因肾血管平滑肌脂肪瘤破裂出血行手术治疗的患者中,近期手术组(n=10)和远期手术组(n=31)在年龄、肿瘤大小、临床症状、手术方式等一般资料上均无统计学差异。但近期手术组较远期手术组术中出血量[(780±451)vs.(572±913)mL,P=0.029]、输血量[(2 600±1 733)vs.(820±582)mL,P=0.027]及切肾率(60.0%vs.22.6%,P=0.027)均明显增高,组间差异具有统计学意义。【结论】肾血管平滑肌脂肪瘤破裂出血患者,保守治疗病情稳定后选择远期手术较近期手术具有更低的围手术期风险。更多还原

【Abstract】 【Objective】To investigate the perioperative risk of different operation times on renal angiomyolipoma(AML)patients with rupture and hemorrhage.【Methods】From January 2006 to December 2016,AML patients withrupture and hemorrhage who receiving surgical treatment were recruited. According to the operation time,patients receivingsurgery within 7 days after the hemorrhage were classified as short-term operation group. Patients receiving surgeryexceeded 30 days after the hemorrhage were classified as long-term operation group. The general and perioperative datawere compared between the two groups.【Results】There were no statistically significant differences in age,tumor size,clinical symptoms and operative methods between the two groups. However,as compared to the long-term operationgroup,the hemorrhage during surgery[(780±451)vs.(572±913)mL,P=0.029],the volume of transfused blood[(2600±1733)vs.(820±582)mL,P=0.027],the nephrectomy rate(60.0% vs. 22.6%,P=0.027)were significantly increasedin the short-term operation group.【Conclusions】A long-term operation group for AML patients with rupture and hemor-rhage could have a lower perioperative risk.更多还原