后腹腔镜肾部分切除术热缺血时间的临床研究  

Clinical study of warm ischemia time during retroperitoneal laparoscopic partial nephrectomy for renal carcinoma

作　　者：郭峰[1] 曹廷帅 高兴华[1] 吴衍麟[1] 董志刚[1] 张龙洋[1] 

机构地区：[1]山东大学附属济南市中心医院泌尿外科,山东济南250013

出　　处：《现代泌尿外科杂志》2015年第3期166-168,共3页Journal of Modern Urology

摘　　要：目的探讨后腹腔镜肾部分切除术热缺血时间对术后患肾肾功能的影响。方法将2010年1月至2012年1月开展的后腹腔镜下肾部分切除术43例分为3组:短缺血组11例(热缺血时间≤20min),中缺血组23例(20min<热缺血时间≤30min),长缺血组9例(30 min<热缺血时间≤40 min)。分别于术前、术后2周、3月、6月、1年、1.5年、2年测定患肾肾小球滤过率(GFR),比较其变化情况,分析后腹腔镜肾部分切除术对肾功能的影响。结果短缺血组:术后2周患肾GFR较术前差异有统计学意义(P<0.05),其余时间点患肾GFR较术前差异无统计学意义(P>0.05)。中缺血组:术后2周、3月患肾GFR较术前差异有统计学意义(P<0.05),其余时间点患肾GFR较术前差异无统计学意义(P>0.05)。长缺血组:术后2周、3月、6月及1年患肾GFR较术前差异有统计学意义(P<0.05),其余时间点患肾GFR较术前差异无统计学意义。结论后腹腔镜肾部分切除术时,应尽力缩短热缺血时间。Objective To explore the effects of warm ischemia time （WIT） on postoperative renal function. Methods A total of 43 patients who underwent retroperitoneal laparoscopic partial nephrectomy during Jan. 2010 to Jan. 2012 were ret- rospectively analyzed. The patients were divided into two treatment groups （low ischemia group： WIT≤20 min; middle ische- mia group： 20 min〈WIT〈30 min） and long ischemia group （30 min〈WIT≤40 min）. The postoperative GFR of the kidney with renal carcinoma after the surgery for 2 weeks, 3 months, 6 months, 1 year, 1.5 year, and 2 years were observed and ana- lyzed. Results In low ischemia group, the GFRs of the kidney with renal carcinoma 2 weeks after surgery were significantly different compared with the pre-operative data. In middle ischemia group, the GFRs of the kidney with renal carcinoma 2 weeks and 3 months after surgery were significantly different compared with the pre-operative data. In the long ischemia group, the GFRs of the kidney with renal carcinoma 2 weeks, 3 months, 6 months and 1 year after surgery were significantly different compared with the pre-operative data. Gonclusion We should try our best to shorten the warm ischemia time in retroperitoneoscopy partial nephrectomy.

关 键 词：后腹腔镜肾部分切除术 肾小球滤过率 热缺血时间 肾癌 

分 类 号：R737[医药卫生—肿瘤]