PADUA评分系统与保留肾单位手术中相关问题的研究  

PADUA nephrometry scoring system in nephron-sparing surgery

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

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518-522,共5页Journal of Clinical Urology

摘　　要：目的:探讨PADUA评分系统在保留肾单位手术(NSS)中与手术时间、热缺血时间、并发症等相关因素的关系。方法:回顾性分析127例次行NSS的124例肾肿瘤患者的临床资料,行PADUA评分,并利用χ2检验、Fisher确切检验等分析PADUA评分与手术时间、热缺血时间、并发症、出血量、术后住院时间、术后第1天血肌酐变化率的关系。结果:PADUA评分低、中、高度复杂肿瘤分别为40例、62例、25例,LNSS组手术时间与PADUA评分有关(P=0.012),ONSS组只有高度与低度复杂肿瘤之间有统计学意义(P=0.005)。对于低度复杂肿瘤,LNSS比ONSS手术时间短(P=0.009)。PADUA评分与热缺血时间相关,与围手术期并发症、术后第1天血肌酐变化率无关。ONSS组出血量与PADUA评分无关,而LNSS组两者有关(P=0.031)。LNSS组高度比低度复杂肿瘤术后住院时间长。结论:PADUA评分与NSS手术时间、热缺血时间等相关因素密切相关,可以预测手术相关结果,指导肾肿瘤的治疗。Objective：To explore the relationship between PADUA scoring system and the relevant factors of nephron-sparing surgery （NSS） including operative time, warm ischemia time, complications and others. Method： Retrospective analysis of 127 NSS for 124 renal cancer patients was taken. Using χ2 test, Fisher exact test we ana- lyzed relationship between PADUA score and the relevant factors of NSS including operative time, warm ischemia time, complications, blood loss, postoperative hospital stay, the rate of change in postoperative first-day serum creatinine. Result.. PADUA score low, medium and high complexity tumors were 40 cases, 62 cases, 25 cases re- spectively. Operation time of LNSS group was related to PADUA score （P= 0. 012）. In ONSS group, only low and high complexity tumors were statistically different （P= 0. 005）. For low complexity tumor, operative time of LNSS was shorter than ONSS （P=0. 009）. PADUA score was related to warm ischemia time, but not related to complications and the rate of change in postoperative first-day serum creatinine. PADUA score had nothing to do with blood loss in ONSS group while they are related in LNSS group （P=0. 031）. Postoperative hospital stay of highly complex tumor was longer than low grade tumors in LNSS group. Conclusion：PADUA score is closely relat- ed to operative time, warm ischemia time and other relevant factors of NSS. Thus we can predict the results of surgery and guide treatment of renal cancer .

关 键 词：肾肿瘤 PADUA评分系统 保留肾单位手术 

分 类 号：R737.11[医药卫生—肿瘤]