后腹腔镜下肾脂肪囊外途径治疗乳糜尿的临床疗效分析  

Clinical analysis of retroperitoneal laparoscopic renal adipose capsule outer pathway in the treatment of chyluria

作　　者：佘先 李仁举 冉强 谢江凌 林杰 杨辉 杜虎[2] 

机构地区：[1]重庆市黔江中心医院泌尿外科,409000 [2]重庆市第三人民医院泌尿科,400014

出　　处：《重庆医学》2013年第22期2613-2615,共3页Chongqing medicine

摘　　要：目的与脂肪囊内完全或次全性游离途径肾蒂淋巴管结扎术进行对比,评价后腹腔镜下肾脂肪囊外途径肾蒂淋巴管结扎术的临床疗效。方法回顾性分析经后腹腔镜下脂肪囊外途径肾蒂淋巴管结扎术(Ⅰ组)及脂肪囊内途径肾脏完全或次全游离行肾蒂淋巴管结扎术(Ⅱ组)的111例乳糜尿患者临床资料,比较两组手术时间、术中出血量、术后镇痛率、术后胃肠功能恢复时间、放置引流管时间、术后恢复工作时间、术后住院时间及术后并发症等指标间的差异。结果Ⅰ组在手术时间、术中出血量、术后镇痛率、术后胃肠功能恢复时间、放置引流管时间、术后恢复工作时间、术后住院时间及术后血尿、肾下垂等并发症方面均优于Ⅱ组,差异有统计学意义(P<0.05)。结论后腹腔镜下肾脂肪囊外肾蒂淋巴管结扎术治疗乳糜尿效果肯定,与脂肪囊内手术途径比较,该方法创伤小、恢复快、复发率低,可完全替代肾脂肪囊完全或次全性游离肾蒂淋巴管结扎手术,值得临床推广。Objective To evaluate the surgical techniques and clinical efficacy of retroperitoneoscopic ligation of renal lymphatic vessels outside adipose capsule and inside adipose capsule for comparison in the treatment of chyluria.Methods Retrospective analysis of the retroperitoneal laparoscopic adipose capsule of kidney pedicle lymphatic duct ligation（group Ⅰ）and adipose capsule pathways in the kidney totally or subtotally free renal pedicle lymphatic ligation（groupⅡ）and 111patients with chyluria clinical data,compared two groups of operation time,bleeding volume,the rate of analgesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications and other index difference.Results Retroperitoneal laparoscopic operation group of adipose capsule in operation time,bleeding volume,postoperative analgesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications were better than the adipose capsule of kidney totally or subtotally free operation group,the difference was statistically significant（P0.05）.Conclusion Retroperitoneal laparoscopic renal adipose capsule of kidney pedicle lymphatic disconnection for the treatment of chyluria effect,and adipose capsule operation ways,the method less trauma,quicker recovery,can completely replace the renal adipose capsule total or Sub-total of free kidney pedicle lymphatic disconnection operation,worthy of clinical application.

关 键 词：乳糜尿 后腹腔镜手术 肾蒂淋巴管结扎术 肾脂肪囊 

分 类 号：R699[医药卫生—泌尿科学]