自制单孔后腹腔镜肾切除术的疗效及安全性评价  

The efficacy and safety evaluation of the home-made single-port device in retroperitoneal laparoscopic nephrectomy

作　　者：赵国斌[1] 唐玉红[2] 张秀梅 李向东[1] 苏宏伟[1] 刘硕[1] 

机构地区：[1]河北北方学院附属第一医院泌尿外科,河北张家口075000 [2]河北北方学院检验学院,河北张家口075000 [3]河北省张家口市沙岭子医院急诊科,河北张家口075000

出　　处：《中国医药导报》2014年第11期17-19,23,共4页China Medical Herald

基　　金：河北省张家口市科学技术与发展指导计划项目(编号1321124D);河北北方学院青年基金项目(编号Q201126)

摘　　要：目的探讨自制单孔装置行后腹腔镜肾切除术的有效性及安全性。方法选择2012年7月~2013年7月解放军总医院泌尿外科行肾切除术患者50例为研究对象,根据手术方式的不同将其分为单孔腹腔镜组和开放手术组,每组各25例,单孔腹腔镜组给予自制单孔装置结合常规腹腔镜器械的手术。比较两组患者手术时间、术中出血量、切口长度、术后肠功能恢复时间、术后下床活动时间、住院时间等方面的差异,并比较白细胞(WBC)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、C反应蛋白(CRP)等指标的变化。结果 50例手术病例均顺利完成,单孔腹腔镜组患者手术时间、出血量、切口长度、术后肠功能恢复时间、下床活动时间、住院时间均优于开放手术组,差异有统计学意义(P<0.05或P<0.01)。单孔腹腔镜组术后第1、3天CRP水平[(20.33±8.29)、(16.87±7.51)mg/L]明显低于开放手术组[(68.31±16.05)、(46.13±12.92)mg/L],差异有高度统计学意义(P<0.01);术后第1、3天WBC[(9.31±1.56)×109、(6.98±2.52)×109/L]、ALT[(40.01±21.44)、(26.66±13.25)U/L]、AST[(35.76±17.78)、(4.43±15.39)U/L]水平均稍低于开放手术组[WBC:(10.31±1.72)×109、(70.3±1.44)×109/L;ALT:(42.13±20.55)、(27.88±14.51)U/L;AST:(36.29±16.55)、(25.78±15.56)U/L],但差异无统计学意义(P>0.05)。结论与传统开放手术相比,自制单孔后腹腔镜肾切除术是一种安全、有效、创伤小的手术方式。Objective To evaluate the efficacy and safety of the home-made single-port device in retroperitonea] la- paroscopic nephrectomy. Methods 50 patients with nephrectomy from July 2012 to July 2013 in Uropoiesis Surgical Department of the PLA General Hospital were selected as study objects, they were divided into single-arch laparoscop- ic group and open surgery group, with 25 cases in each group. Single-arch laparoscopic group were given the operation of home-made single-port device combined with the conventional laparoscopic instruments. The time of operation, amount of bleeding, length of incision, recovery time of postoperation intestinal function, postoperation ambulation time, and hospital stays of two groups were compared, and the changes of WBC, ALT, AST, CRP were recorded and com- pared. Results All the 50 operations completed successfully, the time of operation, amount of bleeding, length of inci- sion, recovery time of postoperation intestinal function, postol^eration ambulation time, and hospital stays of single-arch laparoseopic group were better than those of open surgery group, the differences were statistically significant （P 〈 0.05 or P 〈 0.01）. The CRP concentration of single-arch laparoscopic group in 1 and 3 days after operation [（20.33±8.29）, （16.87±7.51） mg/L] were significantly lower than those of open surgery group [（68.31±16.05）, （46.13e12.92） mg/L], the differences were high statistically significant （P 〈 0.01）, but the level of WBC, ALT and AST in single-arch laparoscopic group in 1 and 3 days after operation [WBC ：（9.31±1.56）×109, （6.98±2.52）×109/L; ALT：（40.01±21.44）, （26.66±13.25 U/ L; AST ： （35.76± 17.78）, （4.43± 15.39）U/L] were little lower than those in open surgery group [WBC ： （10.31 ± 1.72）× 109, （70.3±1.44）×109/L; ALT： （42.13±20.55）, （27.88±14.51）U/L; AST：（36.29±16.55）, （25.78±15.56）U/L], with no statistically significant differences （P 〉 0.05）. Conclusion Compared with

关 键 词：单孔腹腔镜手术 后腹腔镜 肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]