The Clinical Analysis In Patients With Postoperative Of Kidney Neoplasms-associated Disseminated Intravascular Coagulation

Objective:The purpose of this study is to understand the impact of age ,gender, variations of hematological system, clinical stage and types of pathology on patients with ostoperative of kidney neoplasms-associated disseminated intravascular coagulation.Methods: We choose our hospital from January of 2002 to December of 2008, 290 adult patients with concurrent surgical treatment of kidney neoplasms patients, aged 19 to 81 years, with an average age of 52 years; of these women, 115 cases, with an average age of 49 years; male 175 cases, with an average age of 54 years of age. 157 cases of left renal tumor, right kidney tumor 133 patients. Of which 204 cases of clear cell carcinoma of kidney, 8 cases of papillary renal cell carcinoma(RCC), chromophobe RCC in 6 cases, unclassified RCC in 4 cases , multilocular cystic RCC in 3 cases, collecting duct carcinoma in 1 case, hamartoma of kidney in 34 cases, 7 cases of renal pelvis cancer, Wilms tumor 1 in case, sarcomatoid RCC in 12 cases, 2 cases of squamous cell carcinoma, mucinous tubular and spindle cell carcinoma in 1 case, malignant stromal tumor in 1 case, primitive neuroectodermal tumor in 1 case, malignant striated muscle tumor in 1 case, benign mesenchymal tumor in 1 case, pheochromocytoma in 3 cases. To do related to preoperative hematological examination, Statistical volume of intraoperative blood loss, postoperative drainage tubes drainage situation, after relevant clinical symptoms of DIC in patients with a full set of blood investigations DIC Results:There are 290 cases of kidney neoplasms patients were analyzed, DIC of postoperative in 7 cases in total, without the occurrence of postoperative DIC in patients of benign kidney tumor, including 4 cases of clear cell carcinoma, two cases of sarcomatoid RCC, renal pelvis cancer in 1 case, with an average age of 59 years; of these males, 6 cases, with an average age of 62 years; females in 1 case, 39 years old. DIC stages: pre-clinical (former DIC) in 1 case, the early (high coagulation period) in 5cases, the medium (period of low consumption of coagulation) in 1 case, the late (hyper-fibrinolysis period). Using the chi-square test, preoperative determination of fibrinogen (FIB), prothrombin (PT), thromboplastin time (APTT) increased or not, in statistics, P <0.05;age and pathological types of statistics was P <0.005;namely, PT, APTT, FIB, age, pathological type of influence after the occurrence of DIC difference was statistically significant, while the decline in preoperative Plt, single-nucleated cells increased, sex, clinical stage of the impact of differences in the occurrence of DIC after fog statistical significance.Conclusions:1 A benign kidney tumor itself right after the occurrence of DIC had no effect, but a larger tumor rupture hemorrhage patients need attention, you can infusion of red blood cells, plasma and so on.2 malignant kidney tumor patients before PT, APTT, FIB detection of DIC patients with elevated risk of postoperative patients was significantly higher than normal.3 malignant kidney tumors more common in patients with DIC after both 76-85 and 56-65 age groups, significantly higher than other age groups.4 Sarcomatoid renal cell carcinoma and renal pelvis cancer, the incidence of DIC patients was significantly higher than other pathologic types.5 malignant kidney tumor patients before a decline in Plt, mononuclear cells increased, clinical stage, gender, right after the occurrence of DIC had no effect.