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目的探讨肾肿瘤破裂大出血合并多系统器官功能不全的诊断和治疗。方法对15例肾肿瘤破裂大出血并多系统器官功能不全(MSOF)患者的临床诊治资料进行回顾性分析,术前快速行CT检查,积极抗休克,急诊手术,术后积极治疗MSOF,呼吸机辅助呼吸。结果行根治性肾切除术,存活93.33%(14/15),死亡6.67%(1/15)。术后存活者随访1～17年仅1例局部肿瘤复发而再次手术治疗。手术后病理为肾细胞癌8例、肾血管平滑肌脂肪瘤6例、肾动脉瘤1例。结论肾肿瘤破裂大出血为泌尿外科急症,CT可以准确显示出血程度和部位,肾肿瘤破裂大出血应行根治性肾切除,积极救治可逆转MSOF。
Objective To investigate the diagnosis and treatment of renal tumor rupture hemorrhage complicated with multiple system organ dysfunction. Methods The clinical data of 15 cases with rupture of renal tumor and multiple system organ dysfunction (MSOF) were analyzed retrospectively. CT scan, positive anti-shock, emergency operation and postoperative MSOF were actively performed. MSOF, ventilator-assisted Breathe. Results The radical nephrectomy survived 93.33% (14/15) and died 6.67% (1/15). Survival patients were followed up for 1 to 17 years, only 1 case of local tumor recurrence and reoperation. Postoperative pathology of renal cell carcinoma in 8 cases, 6 cases of renal angiomyolipoma, renal aneurysm in 1 case. Conclusion Renal tumor rupture hemorrhage emergency urology, CT can accurately show the degree and location of bleeding, rupture of the renal tumor should be radical nephrectomy, active treatment can be reversed MSOF.