R.E.N.A.L.肾肿瘤评分系统与保留肾单位手术的相关研究  

Research of R.E.N.A.L. nephrometry scoring system in nephron-sparing surgery

作　　者：王洪[1] 刘勇[1] 毛昕[1] 荆涛[1] 钟修龙[1] 孙立江[1] 李延江[1] 纪建磊 姜德田 

机构地区：[1]青岛大学医学院附属医院泌尿外科,山东青岛266000

出　　处：《临床泌尿外科杂志》2014年第6期514-517,共4页Journal of Clinical Urology

摘　　要：目的:探讨R.E.N.A.L.肾肿瘤评分系统用于保留肾单位手术(NSS)方式选择的临床意义。方法:回顾性分析行NSS的124例(127例次)肾肿瘤患者临床资料,按R.E.N.A.L.肾肿瘤评分系统进行评分,运用t检验、χ2检验、Fisher确切检验、logistic回归,分析R.E.N.A.L.肾肿瘤评分系统与NSS方式(腹腔镜或开放)的相互关系。结果:127例次手术中,良性肿瘤14例次,恶性肿瘤113例次;腹腔镜保留肾单位手术(LNSS)71例次,开放保留肾单位手术(ONSS)56例次;R.E.N.A.L.肾肿瘤评分系统低、中、高度复杂肿瘤分别为46例次、58例次、23例次,行LNSS分别为38例次(82.6%)、30例次(51.7%)、3例次(13.0%);LNSS组(5.8±1.9)和ONSS组(8.1±1.7)的R.E.N.A.L.评分均值差异有统计学意义(P<0.05);R.E.N.A.L.肾肿瘤评分系统与LNSS方法的选择有显著相关性(χ2=30.9,P<0.05),低度及大部分中度复杂肿瘤适合行LNSS;单因素R、E、N、L与NSS方法的选择有关,N与LNSS方式关联强度最大,而A、h无明显相关性。结论:R.E.N.A.L.肾肿瘤评分系统可评估肾肿瘤的复杂程度,并可指导NSS方式的选择。Objective：To evaluate the clinical application of R. E. N. A. L. nephrometry score system in deci- sion-making of nephron-sparing surgery （NSS）. Method： Clinical data of 124 patients who underwent 127 nephron- sparing surgeries were analyzed retrospectively. The correlation between R. E. N. A. L. nephrometry score and the type of NSS procedure （laparoscopic or open surgery） was evaluated using t tests, g2 tests, Fisher＇s exact tests and logistic regressions analysis according to R. E. N. A. L. nephrometry score system. Result：Among the 127 cases of NSS, 14 cases were benign and 113 cases were malignancy. There were 71 cases operated by LNSS （laparoscopic nephron-sparing surgery） and 56 ONSS （open nephron-sparing surgery）. The numbers of the low, moderate and high complexity tumors were 46, 58 and 23 respectively, and the numbers of LNSS were 38 （82.6%）, 30 （51. 7% ） and 3 （13.0 % ） respectively. There were significant differences between the laparoscopic surgery group （5.8 ±1.9） and open surgery group （8. 1±1. 7） in terms of their mean nephrometry score （P〈0.05）. R. E. N. A. L. nephrometry score was significantly associated with the type of procedure （laparoscopic or open surgery） （χ2 = 30. 9, P〈0.05）. The low and the most of moderate complexity tumors were suitable for LNSS. Individual compo- nent R. , E. , N. , and L. were statistically significant predictors of the NSS type, and the individual component N was associated with the surgery type most. However, individual component A and h seemed to have no relation- ship with the type. Conclusion：R. E. N. A. L. nephrometry score can evaluate the complexity of renal tumors and di- rect surgeons to choose surgery type.

关 键 词：肾肿瘤 R E N A L 肾肿瘤评分系统 保留肾单位手术 根治性肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]