Clinical Analysis For Hemorrhage During Resection Of Neurofibroma And Literature Review

Background:Neurofibroma is a relatively common benign tumor of soft tissues.Most of neurofibromas derive from peripheral nervous system.They can be divided into solitary(single)neurofibroma and multiple neurofibromatosis,the single one is more common,the multiple is generally called neurofibromatosis.Although the therapy of neurofibroma has made great progress in recent years,there still exist many difficulties.Surgery is the only effective treatment.But the large amount of bleeding during operation is a serious threat of patient safety.Objective:This research aims at analyzing the correlative factors of surgical bleeding,reviewing the hemostasia reported,and reducing bleeding and danger during operation.Method:Patients with neurofibroma,who undergone tumors resection or partial tumors resection at Shandong Provincial hospital between Jan.1st,2000 and Feb.1st,2017 were reviewed,and the amount of surgical bleeding and factors related with hemorrhage were statistically analyzed.The data were analyzed with SPSS software.Then we reviewed hemostasia in literatures.Finally,we summarized the main influencing factors and several different hemostatic methods.Result:There were altogether 34 cases enrolled in the research,including 19 male patients and 15 female patients.Among them,13 cases were only diagnosed with neurofibroma,and 21 cases were diagnosed with neurofibromatosis.In Shandong Provincial hospital,they were treated by tumors resection or partial tumors resection surgery.Then through the logistic regression analysis of related factors,we found that the factor "cross-sectional area of tumor" and "anatomical layers of tumor"are independent risk factor for surgical bleeding,with statistical significance(P<0.10).The factor "use of adrenaline" is a protective factor to surgical bleeding in single factor analysis.but it was not bought into multi-factor regression analysis.The hemostatic methods reported can helps to a certain extent,and they must be used within the scope.Conclusion:1.The factor "cross-sectional area of tumor" and "anatomical layers of tumor" are independent risk factors for surgical bleeding,the latter has greater influence.2.We should complete patients' necessary auxiliary examinations,especially pay attention to check the range and anatomical layers of tumors.So we can fully estimate the bleeding volume.3.The using of adrenaline can reduce surgical bleeding,but its effect can't be sure if tumors are giant or located in muscles.