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巨大肝血管瘤的手术治疗效果和风险因素:单中心经验。

The surgical outcomes and risk factors of giant hepatic haemangiomas: a single centre experience.

机构信息

Department of Special Treatment, Shanghai Eastern Hepatobiliary Surgery Hospital, The 15th floor, No.225 Changhai Road, YangPu district, Shang Hai, 200438, China.

出版信息

BMC Surg. 2022 Jul 17;22(1):278. doi: 10.1186/s12893-022-01721-w.

Abstract

OBJECTIVE

To evaluate the safety of performing surgery on cavernous haemangiomas in the liver larger than 10 cm and establish preoperative predictors of intraoperative blood transfusion and morbidity.

METHODS

A total of 373 patients with haemangiomas larger than 10 cm who underwent surgery in our hospital were retrospectively analysed. According to tumour diameter, the patients were divided into a giant haemangioma (GH) group (241 cases) (10 cm ≤ diameter < 15 cm) and an enormous haemangioma (EH) group (132 cases) (diameter ≥ 15 cm). Clinical parameters were then compared between the two groups.

RESULTS

Compared with the GH group, the EH group had higher rates of leukopenia (10.6% vs. 4.5%), anaemia (26.5% vs. 15.7%), and thrombocytopenia (13.6% vs. 6.2%). The occlusion time in the EH group was longer than that in the GH group (26.33 ± 14.10 min vs. 31.85 ± 20.09 min, P < 0.01). The blood loss and blood transfusion in the EH group were greater than those in the GH group (P < 0.05). Moreover, the morbidity in the EH group was higher than that in the GH group (17.4% vs. 9.13%, P < 0.05). According to the results of the multivariable analysis, the operation time and size of the haemangioma may be independent risk factors for blood transfusion (P < 0.05). Additionally, the size of the haemangioma may be an independent risk factor associated with complications (P < 0.05).

CONCLUSION

Enormous haemangioma is more likely to cause haematologic abnormalities than giant hepatic haemangioma. The risks of the operation and postoperative complications of enormous haemangioma are higher than those of giant hepatic haemangioma.

摘要

目的

评估在肝脏中对大于 10cm 的海绵状血管瘤进行手术的安全性,并建立术中输血和发病率的术前预测因子。

方法

回顾性分析我院 373 例直径大于 10cm 的血管瘤患者,根据肿瘤直径将患者分为巨大型血管瘤(GH)组(241 例)(10cm≤直径<15cm)和巨大型血管瘤(EH)组(132 例)(直径≥15cm)。然后比较两组的临床参数。

结果

与 GH 组相比,EH 组白细胞减少症(10.6%比 4.5%)、贫血(26.5%比 15.7%)和血小板减少症(13.6%比 6.2%)的发生率更高。EH 组的闭塞时间长于 GH 组(26.33±14.10min 比 31.85±20.09min,P<0.01)。EH 组的出血量和输血量大于 GH 组(P<0.05)。此外,EH 组的发病率高于 GH 组(17.4%比 9.13%,P<0.05)。多变量分析结果显示,手术时间和血管瘤大小可能是输血的独立危险因素(P<0.05)。此外,血管瘤的大小可能是与并发症相关的独立危险因素(P<0.05)。

结论

巨大型肝血管瘤比巨大型肝血管瘤更容易引起血液学异常。巨大型肝血管瘤的手术风险和术后并发症的风险高于巨大型肝血管瘤。

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