单孔后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的疗效评估  

Assessment on the Perioperative Efficacy of Single-Port Retroperitoneoscopic Ligation of Renal Pedicle Lymphatic Vessels in Treating Chyluria

作　　者：李文威[1] 

机构地区：[1]黄石市中心医院,黄石435000

出　　处：《基因组学与应用生物学》2017年第6期2337-2342,共6页Genomics and Applied Biology

基　　金：湖北黄石市中心医院普爱院区泌尿外科资助

摘　　要：为了探讨单孔后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的效果。本研究将68例采用腹腔镜肾蒂淋巴管结扎术治疗的乳糜尿患者随机分为单孔组(29例)和多孔组(39例)。对比两组手术指标、术后恢复指标、术后并发症发生率,并血红蛋白、白蛋白及肾小球滤过率。采用六点行为评分法(BRS-6)评估患者疼痛程度,采用视觉评分量表(VAS)评估瘢痕组织满意度;随访至2015年3月,比较复发率、远期并发症发生率。研究表明,单孔组手术时间长于多孔组,切口长度短于多孔组(p<0.05);单孔组术后1 d、5 d的BRS-6评分低于多孔组,术后VAS满意度评分高于多孔组(p<0.05);两组术后血红蛋白、白蛋白上升,肾小球滤过率下降,同组治疗前后相比,差异明显(p<0.05),两组术后组间对比无明显差异(p>0.05);两组术后恢复时间、术后并发症、远期并发症及复发率比较无差异(p>0.05)。单孔后腹腔镜肾蒂淋巴管结扎术可取得与多孔腹腔镜手术同等的远期效果,且在减轻术后疼痛、缩短瘢痕长度方面更具优势。To explore the efficacy of single-port retroperitoneoscopic ligation of renal lymphatic vessels in treating chyluria, this study randomly divided 68 patients with chyluria who were treated by retroperitoneoscopic ligation of renal lymphatic vessels into the single-port group （29 cases） and the porous group （39 cases）. The operation indexes, postoperative recovery indexes, the incidence of postoperative complications, hemoglobin, albumin and glomerular filtration rate were compared between the two groups. The pain degree of patients was evaluated by six-point behavioral rating scale （BRS-6）, and the satisfaction of scar tissues was evaluated by the visual analogue scale （VAS）. All patients were followed up till March 2015, and the recurrence rate and incidence of long-term complications were compared. The results showed that the operation time of single-port group was longer than the porous group, and the length of incision was shorter than the porous group （p〈0.05）. The BRS-6 scores of the single-port group in 1 day and 5 days after operation were lower than the porous group, but the postoperative VAS satisfaction scores were higher than the porous group （p〈0.05）. After operation, hemoglobin and albumin in the two groups increased while the glomerular filtration rate decreased （p〈0.05）. The difference was significant in the same group before and after operation （p 〈0.05）, but there were no statistically significant differences between the two groups after operation （p〉0.05）. Moreover, there were no statistically significantdifferences in postoperative recovery time, postoperative complications, long-term complications and recurrence rate between the two groups （p〉0.05）. In conclusion, the long-term effect of single-port retroperitoneoscopic ligation of renal lymphatic vessels was same with porous laparoscopic operation, but the former had more advantages in relieving pain after operation and reducing length of incision.

关 键 词：乳糜尿 肾蒂淋巴管结扎术 单孔腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]