腹腔镜下非阻断肾动脉肾部分切除术治疗T_(1a)期肾癌的效果分析  

Effect analysis of laparoscopic partial nephrectomy without blocking renal artery for T_(1a) stage of renal cell carcinoma

作　　者：姜利宁[1] 季德才[1] 鄂文娜 郝斌[1] 李宏志[1] 董永良[1] 李英杰 

机构地区：[1]河北医科大学附属沧州市中心医院泌尿外一科,河北沧州061000 [2]河北省沧州市新华区建北社区服务中心,河北沧州061000

出　　处：《中国医药导报》2017年第9期70-73,共4页China Medical Herald

基　　金：河北省沧州市科技计划项目(151302134)

摘　　要：目的观察腹腔镜下对T_(1a)期肾癌患者行非阻断肾动脉肾部分切除术的效果。方法选取2012年6月~2015年1月河北医科大学附属沧州市中心医院(以下简称"我院")收治的行非阻断肾动脉肾部分切除术的11例T_(1a)期肾癌患者作为观察组,同时选取2008年1月~2012年5月我院行传统阻断肾动脉的后腹腔镜肾部分切除术的16例T_(1a)期肾癌患者作为对照组。比较两组手术指征、检测指标、预后情况。采取SPSS 21.0软件行统计学分析。结果两组患者的手术时间、术中出血量、术后排气时间、术后排便时间、术后住院时间比较,差异无统计学意义(P>0.05)。观察组术前血清肌酐(Scr)、尿素氮(BUN)、患肾肾小球滤过率(GFR)水平分别为(101.12±21.54)μmol/L、(3.60±0.19)μmol/L、(42.24±5.26)m L/min,术后分别为(98.96±26.36)μmol/L、(3.64±0.23)μmol/L、(41.57±4.92)m L/min,术前术后比较差异均无统计学意义(均P>0.05);对照组术前Scr、BUN、GFR水平分别为(99.73±17.02)μmol/L、(3.62±0.28)μmol/L、(41.84±6.01)m L/min,术后分别为(110.85±16.01)μmol/L、(4.85±0.39)μmol/L、(32.20±4.62)m L/min,术后Scr、BUN水平较术前显著升高,而GFR水平较术前显著下降,差异有统计学意义(P<0.05);两组间比较,术前各指标差异无统计学意义(P>0.05);术后观察组Scr、BUN水平低于对照组,GFR水平高于对照组,差异有统计学意义(P<0.05)。观察组术中输血率为9.09%,对照组为6.25%,两组比较差异无统计学意义(P>0.05)。观察组术后无并发症,对照组术后发生1例输尿管损伤,两组并发症发生率比较差异无统计学意义(P>0.05)。经1年随访,两组患者均无一例复发。结论腹腔镜下对T_(1a)期肾癌患者行非阻断肾动脉肾部分切除术可取得与传统手术相似的效果,且能避免肾脏热缺血,改善肾脏微循环灌注与肾小球滤过功能,值得推广应用。Objective To observe the effect of laparoscopic partial nephrectomy without blocking renal artery for pa- tients with Tla stage of renal cell carcinoma. Methods 11 patients with Tla stage of renal cell carcinoma underwent la- paroscopic partial nephrectomy without blocking renal artery in Cangzhou Central Hospital Affiliated to Hebei Medical University （＂our hospital＂ for short） from June 2012 to January 2015 were selected as the observation group. While 16 patients with Tla stage of renal cell carcinoma underwent laparoscopic partial nephrectomy with blocking renal artery in our hospital from January 2008 to May 2012 were selected as the control group. Indications of operation, detection in- dex and prognosis were compared between two groups. SPSS 21.0 software was used for statistical analysis. Results Duration of operation, intraoperative blood loss, postoperative exhaust time, postoperative defecation time, postoperative hospitalization time between the two groups had no significant differences （P 〉 0.05）. In the observation group, preoper- ative levels of Scr ,BUN, GFR were （101.12±21.54） μmol/L, （3.60±0.19） μmol/L, （42.24±5.26） mL/min respectively; postoperative levels of Scr ,BUN, GFR were （98.96±26.36） μmol/L, （3.64±0.23） μmol/L, （41.57±4.92） mL/min respec- tively. There were no statistically significant differences in these indications between before and after operation in the observation group （P 〉 0.05）. In the control group, pre-operative levels of Scr, BUN, GFR were （99.73±17.02） μmol/L, （3.62±0.28） μmol/L, （41.84±6.01） mL/min respectively, postoperative levels of Scr ,BUN, GFR were （110.85±16.01） μmol/L, （4.85±0.39） μmol/L, （32.20±4.62） mL/min respec- tively. After operation the levels of Ser and BUN significantly higher than those of before operation, and GFR level was significantly lower than that of before operation, with statistically significant differences （P 〈 0.05）. Comparison between the two groups

关 键 词：腹腔镜 非阻断肾动脉 肾部分切除术 T1a期肾癌 

分 类 号：R734[医药卫生—肿瘤]