北疆地区肝血管瘤治疗现状的相关研究
发布时间：2018-11-10 21:47
【摘要】：目的:通过对新疆北疆地区肝血管瘤患者进行回顾性分析,了解肝血管瘤治疗的现状,对医疗干预情况进行分析,为新疆地区居民健康服务提供一定的帮助。并为进一步探索肝血管瘤治疗的干预条件、干预时机和干预手段的临床研究提供新的研究思路。方法:回顾性分析石河子大学医学院第一附属医院、兰州军区乌鲁木齐总医院、新疆生产建设兵团总医院、新疆伊犁州奎屯医院、新疆生产建设兵团农四师医院、新疆生产建设兵团农五师医院、新疆生产建设兵团农十师医院、新疆生产建设兵团北屯医院、哈密红星医院、新疆阿勒泰地区人民医院、新疆生产建设兵团农九师医院、新疆石河子市人民医院(新疆生产建设兵团农八师医院)、新疆乌苏市人民医院、新疆沙湾县人民医院等14所医院2011年1月1日至2013年12月31日诊断为肝血管瘤并住院治疗的病例,采用统一的调查表系统、全面的收集各种资料,包括患者基本信息(年龄、性别、民族、学历、医保状况、经济情况、家族史等),诊断相关信息(诊断机构、诊断方式、肝血管瘤大小、位置、形状等),治疗相关信息(治疗方式、预后情况等),医护人员肝血管瘤知识认知情况。结果:共纳入415例肝血管瘤患者,其中男性159例(38.31%),女性256例(61.69%),男女比例为1∶1.61,肝血管瘤患者在41~60岁区间所占比例最高(286例,68.92%);职业分布以非农户产业工人98例(23.61%),农业劳动者(从事农林牧渔工作)82例(19.76%),离退休人员53例(12.77%),比例较大,占主要部分;2011年至2013年收治肝血管瘤病人构成比是28.92%(120例),30.36%(146例),35.9%(149例),各年收治人数无明显那增大趋势。.本研究415例患者中,汉族352例(84.82%),少数民族患者63例(16.18%);本研究中肿瘤位置207例(49.8%)瘤体位于肝右叶,最为常见,同时不同性别患者的肝血管瘤瘤体位置分布不同(2=124.002,P=0,P0.05);瘤体病灶最大径位于1.0—30cm之间,平均9.06±4.02 cm,肿瘤大小与患者性别无关(P0.05)。单发者226例(54.46%),多发者189例(45.54%)。单发或多发病灶在性别分布上的差异无统计学意义(P0.05),提示性别不是影响肝血管瘤个数的因素。本组病例病程3个月~12年,平均20.1±6.2个月;其中286例(68.02%)无任何临床症状及体征,随着直径的增大患者出现症状体征的几率增加(P0.05)。126例手术切除患者术后病检发现,肝海绵状血管瘤121例96.03%),硬化性能肝血管瘤5例(3.97%),干预方式以经腹腔瘤体切除除术110例(26.51%),肝动脉介入栓塞术90例(21.69%)最为常见,手术方式的选择则受瘤体位置、大小、数量、症状体征、患者年龄、性别、就诊机构等的影响(P0.05)。262例(63.13%)患者行干预治疗,符合上述指证一项或多项的患者有140例(53.44%),有122例(46.56%)患者者无任何干预指证,属于过度干预治疗,而且二级医院过度干预情况较三级医院严重。三级医院医护人员对肝血管瘤认知程度较二级医院高。结论:1.北疆地区肝血管瘤患者在不同性别、年龄、职业、民族、文化程度等方面分部具有一定规律;肝血管瘤大小、位置、个数、症状及体征具有一点的特征性;2.北疆地区肝血管瘤干预方式多样化,肝血管瘤切除术、TAE是最常用的干预手段,肝血管瘤患者瘤体位置、大小、数量、症状体征、患者年龄、性别、就诊机构的不同其治疗方式不同;3.北疆地区肝血管瘤存在一定的过度干预情况,二级医院就诊的患者更容易出现过度干预治疗,其原因可能有患者健康意识不足、经济利益驱使、基层医生对疾病认识不足等多种原因。4.三级医院医护人员对肝血管瘤相关知识的认知度较二级医院高。
[Abstract]:Objective: To study the status of the treatment of hepatic hemangioma and to provide some help to the health service of the residents in Xinjiang, through a retrospective analysis of the patients with hepatic hemangioma in the northern part of Xinjiang. In order to further explore the intervention conditions, the time of intervention and the means of intervention in the treatment of hepatic hemangioma, a new approach is provided. Methods: The first Affiliated Hospital of Shihezi University, Urumqi General Hospital of Lanzhou Military Region, General Hospital of Xinjiang Production and Construction Corps, Kuitun Hospital, Xinjiang Production and Construction Corps, the Fourth Division Hospital of Xinjiang Production and Construction Corps, and the Hospital of the 5th Division of the Xinjiang Production and Construction Corps were analyzed retrospectively. Xinjiang Production and Construction Corps, Nun Shishi Hospital, Xinjiang Production and Construction Corps, Beitun Hospital, Hami Hongxing Hospital, People's Hospital of Xinjiang Altai District, Xinjiang Production and Construction Corps, N9 Division Hospital, People's Hospital of Shihezi City, Xinjiang (Eighth Division of the Xinjiang Production and Construction Corps), From January 1, 2011 to December 31, 2013, the People's Hospital of the Wusu City of Xinjiang and the People's Hospital of Shawan County, Xinjiang, and the cases of hospitalization for the diagnosis of hepatic hemangioma on January 1, 2011 and December 31, 2013, the unified questionnaire system was adopted to collect various data comprehensively, including the basic information of the patient (age, sex, The knowledge of the knowledge of liver hemangioma of medical staff, such as national, educational background, medical insurance, economic situation, family history, etc.), diagnosis-related information (diagnosis, diagnosis, hepatic hemangioma size, position, shape, etc.), treatment-related information (treatment mode, prognosis, etc.), and knowledge of liver hemangioma of medical personnel. Results: A total of 415 cases of hepatic hemangioma were included, including 159 (38. 31%), 256 (61.69%) women, 1: 1.61, and the highest in the 41 ~ 60 years (286 cases, 68. 92%). The occupational distribution was 98 cases (23.61%) of non-farm workers. 82 cases (19. 76%) and 53 (12. 77%) of the retired workers (12. 77%) were the major part. The composition ratio of the patients with hepatic hemangioma from 2011 to 2013 was 28. 92% (120 cases), 30. 36% (146 cases), 35. 9% (149 cases), and there was no significant increase in the number of patients in each year. Among the 415 patients, there were 352 (84. 82%) of the Han and 63 (16. 18%) of the minority, and 207 (49. 8%) of the tumors in the study were located in the right lobe of the liver, most commonly, while the position distribution of the hepatic hemangioma in different sex patients was different (2 = 124. 002, P = 0, P <0.05). The maximum diameter of the tumor was located in the range of 1. 0 to 30 cm, with an average of 9.06 to 4.02 cm, and the size of the tumor was not related to the sex of the patient (P0.05). There were 226 cases (54. 46%) and 189 cases (45. 54%). There was no significant difference in the distribution of the single or multiple incidence (P0.05), and the suggestive value was not the factor that affected the number of the hepatic hemangioma. The course of this group was 3 months to 12 years, with an average of 20. 1 to 6. 2 months, of which 286 cases (62.02%) had no clinical symptoms and signs, and with the increase of the diameter, the incidence of symptoms and signs increased (P0.05). There were 5 cases (3.97%) of sclerosing hepatic hemangiomas, and 110 cases (26. 51%) and 90 (21. 69%) of hepatic artery interventional embolization were the most common in the treatment of hepatic hemangioma, and the choice of operation was controlled by the location, size, number, sign of symptoms, age and sex of the patient. There were 140 cases (55.3. 44%) of the patients with one or more of the above-mentioned indications, and 122 (46. 56%) of the patients had no intervention, and they were over-intervention. in addition, that level of excessive intervention of the second-level hospital is more serious than that of the third-level hospital. The level of cognition of hepatic hemangioma is higher in the third-level hospital. Conclusion: 1. The patients with hepatic hemangioma in northern Xinjiang have a certain rule in different sex, age, occupation, national and cultural degree, and the size, location, number, symptom and sign of hepatic hemangioma have a certain characteristic; 2. In Northern Xinjiang, the mode of hepatic hemangioma was diversified, and the resection of hepatic hemangioma and TAE were the most common methods of intervention. The location, size, number, sign of symptoms, age, sex and treatment of the patients with hepatic hemangioma were different. There are some over-intervention in the hepatic hemangioma in the northern part of Xinjiang, and the patients in the second-level hospital are more likely to be treated with excessive intervention. The reason may be that the patient's health consciousness is insufficient, the economic benefit is driven, and the basic doctor has many reasons for lack of knowledge of the disease. The cognition of the knowledge of the related knowledge of hepatic hemangioma is higher in the third-level hospital.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7
本文编号：2323699
[Abstract]:Objective: To study the status of the treatment of hepatic hemangioma and to provide some help to the health service of the residents in Xinjiang, through a retrospective analysis of the patients with hepatic hemangioma in the northern part of Xinjiang. In order to further explore the intervention conditions, the time of intervention and the means of intervention in the treatment of hepatic hemangioma, a new approach is provided. Methods: The first Affiliated Hospital of Shihezi University, Urumqi General Hospital of Lanzhou Military Region, General Hospital of Xinjiang Production and Construction Corps, Kuitun Hospital, Xinjiang Production and Construction Corps, the Fourth Division Hospital of Xinjiang Production and Construction Corps, and the Hospital of the 5th Division of the Xinjiang Production and Construction Corps were analyzed retrospectively. Xinjiang Production and Construction Corps, Nun Shishi Hospital, Xinjiang Production and Construction Corps, Beitun Hospital, Hami Hongxing Hospital, People's Hospital of Xinjiang Altai District, Xinjiang Production and Construction Corps, N9 Division Hospital, People's Hospital of Shihezi City, Xinjiang (Eighth Division of the Xinjiang Production and Construction Corps), From January 1, 2011 to December 31, 2013, the People's Hospital of the Wusu City of Xinjiang and the People's Hospital of Shawan County, Xinjiang, and the cases of hospitalization for the diagnosis of hepatic hemangioma on January 1, 2011 and December 31, 2013, the unified questionnaire system was adopted to collect various data comprehensively, including the basic information of the patient (age, sex, The knowledge of the knowledge of liver hemangioma of medical staff, such as national, educational background, medical insurance, economic situation, family history, etc.), diagnosis-related information (diagnosis, diagnosis, hepatic hemangioma size, position, shape, etc.), treatment-related information (treatment mode, prognosis, etc.), and knowledge of liver hemangioma of medical personnel. Results: A total of 415 cases of hepatic hemangioma were included, including 159 (38. 31%), 256 (61.69%) women, 1: 1.61, and the highest in the 41 ~ 60 years (286 cases, 68. 92%). The occupational distribution was 98 cases (23.61%) of non-farm workers. 82 cases (19. 76%) and 53 (12. 77%) of the retired workers (12. 77%) were the major part. The composition ratio of the patients with hepatic hemangioma from 2011 to 2013 was 28. 92% (120 cases), 30. 36% (146 cases), 35. 9% (149 cases), and there was no significant increase in the number of patients in each year. Among the 415 patients, there were 352 (84. 82%) of the Han and 63 (16. 18%) of the minority, and 207 (49. 8%) of the tumors in the study were located in the right lobe of the liver, most commonly, while the position distribution of the hepatic hemangioma in different sex patients was different (2 = 124. 002, P = 0, P <0.05). The maximum diameter of the tumor was located in the range of 1. 0 to 30 cm, with an average of 9.06 to 4.02 cm, and the size of the tumor was not related to the sex of the patient (P0.05). There were 226 cases (54. 46%) and 189 cases (45. 54%). There was no significant difference in the distribution of the single or multiple incidence (P0.05), and the suggestive value was not the factor that affected the number of the hepatic hemangioma. The course of this group was 3 months to 12 years, with an average of 20. 1 to 6. 2 months, of which 286 cases (62.02%) had no clinical symptoms and signs, and with the increase of the diameter, the incidence of symptoms and signs increased (P0.05). There were 5 cases (3.97%) of sclerosing hepatic hemangiomas, and 110 cases (26. 51%) and 90 (21. 69%) of hepatic artery interventional embolization were the most common in the treatment of hepatic hemangioma, and the choice of operation was controlled by the location, size, number, sign of symptoms, age and sex of the patient. There were 140 cases (55.3. 44%) of the patients with one or more of the above-mentioned indications, and 122 (46. 56%) of the patients had no intervention, and they were over-intervention. in addition, that level of excessive intervention of the second-level hospital is more serious than that of the third-level hospital. The level of cognition of hepatic hemangioma is higher in the third-level hospital. Conclusion: 1. The patients with hepatic hemangioma in northern Xinjiang have a certain rule in different sex, age, occupation, national and cultural degree, and the size, location, number, symptom and sign of hepatic hemangioma have a certain characteristic; 2. In Northern Xinjiang, the mode of hepatic hemangioma was diversified, and the resection of hepatic hemangioma and TAE were the most common methods of intervention. The location, size, number, sign of symptoms, age, sex and treatment of the patients with hepatic hemangioma were different. There are some over-intervention in the hepatic hemangioma in the northern part of Xinjiang, and the patients in the second-level hospital are more likely to be treated with excessive intervention. The reason may be that the patient's health consciousness is insufficient, the economic benefit is driven, and the basic doctor has many reasons for lack of knowledge of the disease. The cognition of the knowledge of the related knowledge of hepatic hemangioma is higher in the third-level hospital.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7
【参考文献】
相关期刊论文 前3条
1 邹华;马宽生;;射频消融治疗肝血管瘤的现状[J];临床肝胆病杂志;2013年08期
2 杜锡林,马庆久,赵柏山,卞玲;B超引导下集束电极射频热毁损治疗肝脏海绵状血管瘤[J];中国实用外科杂志;2001年12期
3 丛文铭,吴孟超,王一,张秀忠,陈汉;肝脏肿瘤3160例临床病理研究[J];中华病理学杂志;1997年02期
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