中国人群体重指数对腹膜后腹腔镜肾部分切除术的影响  

Effect of body mass index on retroperitoneal laparoscopic partial nephrectomy in Chinese patients

作　　者：赵峥[1] 孟一森[1] 范宇[1] 李德润[1] 张骞[1] 谌诚[1] 虞巍[1] 王宇[1] 周利群[1] 李学松[1] 

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,北京100034

出　　处：《解放军医学杂志》2013年第12期992-995,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的比较不同体重指数（BMI）人群行腹膜后腹腔镜肾部分切除术同术期临床指标的差异。方法回顾性分析2005年6月-2012年6月409例在北京大学第一医院泌尿外科接受腹膜后腹腔镜肾部分切除术患者的临床资料。409例患者中男261N，女148例，年龄50．1±12．2（15～81）岁，BMI25．1±3．6（15．6～37．1）kg／m^2。根据BMI将患者分为肥胖组（BMI≥28kg／m^2，87例）和非肥胖组（BMI〈28kg／m^2，322例），比较两组围术期的相关临床数据。结果肥胖组手术时间（147．0±61．6min）和住院时间（14．2±8．1d）均明显长于非肥胖组（分别为130．0±47．9min和111．7±5．3d，P=0．018，P=0．000），住院费用（32444．2±16584．8元）高于非肥胖组（28239．7±6485．7，P=0．000），术中及术后早期并发症发生率（分别为11．5％、6．9％）与非肥胖组（分别为6．2％和3．7％）比较差异无统计学意义（P=0．106，P=O．201）。两组患者年龄、术中热缺血时间、集合系统修复率、出血量、肿瘤直径、位置、良恶性等比较均无明显差异。结论肥胖患者行腹膜后腹腔镜肾部分切除术是安全可行的，与非肥胖患者围术期并发症无明显差异，但手术时间更长，表明随BMI增加，腹膜后腹腔镜肾部分切除术的难度增大。Objective To compare the perioperative clinical characteristics of patients with different body mass index （BMI） undergoing retroperitoneal laparoscopic partial nephrectomy. Methods The clinical data of 409 patients （male 261, female 148, aged 15-81 （50.1 ± 12.2） years, having received retroperitoneal laparoscopic partial nephrectomy from June 2005 to June 2012 in the Department of Urology, First Hospital of Peking University） were retrospectively analyzed. The BMI of these 409 patients was 15.647.1（25.1 ± 3.6）kg/m2. According to the BMI values, these 409 patients were divided into nonobese group （BMI〈28kg/ m^2, n=322） and obese group （BMI I〉 28kg/m^2, n=87）, and the perioperative clinical data of the two groups were compared. Results The operative time and length of stay of obese group （147.0 ± 61.6min, 14.2 ± 8.1d） were longer than those of nonobese group （ 130.0 ± 47.9min, 11.7 ± 5.3d, P=0.018, P=0.000, respectively）. The hospital cost of obese group （32 444.2 ± 16 584.8 Yuan） was higher than that of nonobese group （28 239.7 ± 6485.7 Yuan, P=0.000）. The incidence of intraoperative and postoperative complications of obese group （11.5%, 6.9%） was similar to those of nonobese group （6.2%, 3.7%, P=0.106, P=0.201, respectively）. There was no significant difference between the two groups in age, warm ischemia time, collecting system repair rate, blood loss, tumor location and size, or the tumorous property （benign or malignant）. Conclusions Retroperitoneal laparoscopic partial nephrectomy is safe for obese patients, and the incidence of perioperative complication is similar to that for nonobese patients, but the operative time is longer than that of nonobese patients, implying that the operative difficulty would be increased with an increase in BMI.

关 键 词：肾部分切除术 腹腔镜检查 腹膜后间隙 体重指数 

分 类 号：R692[医药卫生—泌尿科学]