R.E.N.A.L.评分系统在经腹腹腔镜肾部分切除术治疗T1a期肾肿瘤中的应用  

Application of R.E.N.A.L.nephrometry score for transperitoneal laparoscopic partial nephrectomy in renal tumor of T1a stage

作　　者：郝强[1] 薛芃[1] 宗焕涛[1] 张勇[1] Hao Qiang;Xue Peng;Zong Huantao;Zhang Yong.(Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京100050

出　　处：《中华腔镜泌尿外科杂志（电子版）》2018年第1期53-56,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨肾脏肿瘤测量评分系统(R.E.N.A.L.评分系统)在T1a期肾肿瘤行经腹入路腹腔镜肾部分切除术(TLPN)中的应用价值。方法回顾性分析2010年7月至2016年10月首都医科大学附属北京天坛医院泌尿外科67例行TLPN的T1a期肾肿瘤患者的临床资料,其中男52例(78%),女15例(22%),年龄26~75岁,平均(56±13)岁。肿瘤平均直径(2.5±0.8)cm,其中左侧32例(48%),右侧35例(52%);应用R.E.N.A.L.评分系统对肾脏肿瘤进行量化评分。比较低、中与高评分组在肿瘤最大径、热缺血时间、术中出血量、手术时间、术前术后肌酐及住院天数等临床指标的差异。结果 67例患者均顺利完成TLPN,无中转开放及死亡病例。平均R.E.N.A.L.评分为(6.3±1.7)分,其中低评分组有37例(55%),中评分组有24例(36%),高评分组有6例(9%),低、中与高评分组肿瘤最大直径差异有统计学意义(F=5.230,P=0.008),热缺血时间、术中出血量、手术时间、术前术后肌酐及住院天数差异均无统计学意义(P>0.05)。结论使用R.E.N.A.L.评分系统评估TLPN治疗T1a期肾肿瘤手术风险及手术难易程度的价值有限,临床应用需慎重。Objective To evaluate R.E.N.A.L. nephrometry score for transperitoneal laparoscopic partial nephrectomy（TLPN）. Methods Between July 2010 and October 2016, 67 cases（52 males and 15 females） underwent TLPN. Mean age was（56±13） years, mean tumor size was（2.5 ± 0.8） cm in diameter, 32 cases（48%） on the left side and 35 cases（52%） on the right side. R.E.N.A.L. nephrometry score were evaluated in tumor size, warm ischemia time, intraoperative blood loss, operation time, preoperative and postoperative creatinine and hospitalization days. Results Sixty-seven patients were successfully completed TLPN, no conversion to open surgery and deaths. Mean R.E.N.A.L.score was（6.3± 1.7）. 37 cases（55%）, 24 cases（36%） and 6 cases（9%） were enrolled in low, moderate and high score group, respectively. There were significant differences between patients of different R.E.N.A.L.score groups in tumor size（F=5.230, P=0.008）. There was no difference in warm ischemia time, intraoperative blood loss, operation time, preoperative and postoperative creatinine and hospitalization days（P〈0.05）. Conclusions In patients with T1a kidney tumor undergoing TLPN, the value of R.E.N.A.L. nephrometry score is limited in clinical application.

关 键 词：R.E.N.A.L.评分 腹腔镜 肾部分切除术 肾脏肿瘤 

分 类 号：R737.11[医药卫生—肿瘤]