腹腔镜囊肿去顶减压术联合肾脏被膜剥脱术治疗常染色体显性遗传性多囊肾病的安全性及有效性评估  

Laparoscopic Cyst Decompression Combined with Renal Capsule Decortication Surgery for Autosomal Dominant Polycystic Kidney Disease

作　　者：李斌[1] 张沂南[1] 金讯波[1] 夏庆华[1] 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250021

出　　处：《泌尿外科杂志（电子版）》2011年第2期4-6,共3页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的评估腹腔镜囊肿去顶减压术联合肾脏被膜剥脱术治疗常染色体显性遗传性多囊肾病的安全性及有效性。方法对本中心自2009年1月至2011年1月由同一术者采用腹腔镜多囊肾囊肿去顶减压术联合肾脏被膜剥脱术治疗的20例常染色体显性遗传性多囊肾患者进行前瞻性研究,收集患者手术时间、术中估计失血量及术后住院天数,并对比手术前后肾功能、肾脏体积、囊肿大小、血压及疼痛程度等多项指标。结果 20例多囊肾囊肿去顶减压术联合肾脏被膜剥脱术均获成功,无输血病例,无术中转开放手术病例,围手术期未发生严重并发症。手术时间65～194min,平均106min,术中估计失血量20～180ml,平均39ml。术后4～10天出院,所有病理诊断均为多囊肾囊壁组织。随访6～24个月,平均16.7±2.4个月,术后6～24个月术前所有存在腰腹部疼痛的腰腹痛症状均有明显减轻,术后所有患者肾功能均有明显改善;13例血压升高者术后6～24个月收缩压下降18～30mmHg;所有患者术侧肾脏体积及最大囊肿体积均有明显缩小(P均<0.05)。结论腹腔镜囊肿去顶减压术联合被膜剥脱术治疗常染色体显性遗传性多囊肾病方法可靠,短期疗效确切,创伤小,术后恢复快,手术安全性高,可有效地减轻囊肿对肾脏本身的压迫,从而尽可能的保护残余肾组织的功能。Objective This prospecitve study was to evaluate the safety and efficacy of laparoscopic cyst decompression combined with renal capsule decortication(LCDRAP) in patients with autosomal dominant polycystic kidney disease(ADPKD).Methods From January 2009 to January 2011,20 ADPKD patients were treated with LCDRAP and clinical data,such as operation time,estimated blood loss,postoperative hospital stay,renal function,were collected and analyzed with SPSS for statistical test.Results All 20 cases of LCDRAP were done successfully.The operation time was 65～194min(106min in average),and the estimated blood loss was 20～180 ml(39 ml in average).The postoperative hospital stay was 4～10 days.All the pathological findings were cyst wall tissue of ploycystic kidney.All patients were followed up for 6～24 months(16.7 months in average).Renal function improved in all cases.In 13 patients with a high blood pressure,the systolic pressure was decreased by 18～30mmHg.The size of the kidneys and the largest cysts statistically decreased(P<0.05).Conclusions LCDRAP is a safe and effective procedure for the treatment of ADPKD.

关 键 词：常染色体显性遗传性多囊肾病 腹腔镜囊肿去顶减压术 肾脏被膜剥脱术 

分 类 号：R699.2[医药卫生—泌尿科学]