后腹腔镜肾囊肿去顶术对患者血压影响的研究  

A STUDY OF BLOOD PRESSURE CHANGES DURING RETROPERITONEAL LAPAROSCOPIC RENAL CYST UNROOFING

作　　者：李双利[1] 李守宾[2] 马建锋[3] 于春红[1] 沙泉[3] 邢爱君[1] 刘学伟 李连印[1] 高双友[1] Li Shuangli;Li Shoubin;Ma Jianfeng(Department of Urology,Kailuan General Hospital,Tangshan 063000,Chin)

机构地区：[1]开滦总医院,河北省唐山市063000 [2]河北省人民医院 [3]保定市第一医院

出　　处：《中国煤炭工业医学杂志》2018年第3期225-229,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技厅指令性计划项目(编号:14277734D)

摘　　要：目的前瞻性研究单侧后腹腔镜肾囊肿去顶术对患者血压的影响。方法选取2014年9月—2015年10月在开滦总医院就诊且符合入选标准的52例接受单侧后腹腔镜肾囊肿去顶术的患者为研究对象,分别于术前、术后3个月、术后6个月、术后1年时测量血压,同时检测血浆肾素血管紧张素醛固酮水平,对结果进行分析;按术前有无高血压分为高血压组及非高血压组,分别比较二组患者术前与术后1年时的血压变化。结果所有患者的术前、术后3个月、术后6个月、术后1年时的平均收缩压分别为(131.25±15.37)mmHg、(123.96±9.76)mmHg、(130.04±11.63)mmHg、(130.50±13.96)mmHg,平均舒张压分别为(81.79±9.66)mmHg、(73.56±6.52)mmHg、(81.63±8.50)mmHg、(81.60±8.65)mmHg。与术前比较,术后3个月时收缩压及舒张压均明显下降,差异有统计学意义(P<0.05),而术后6个月、术后1年时的血压比较差异无统计学意义(P>0.05);术前、术后3个月、术后6个月、术后1年的肾素、血管紧张素、醛固酮水平的变化趋势与血压变化趋势一致,术后3个月的指标水平较术前明显下降,差异有统计学意义(P<0.05);高血压组患者平均收缩压术前为(141.67±13.23)mmHg,术后1年时为(136.59±12.63)mmHg,差异有统计学意义(P<0.05);平均舒张压术前为(88.07±8.4)mmHg,术后1年时为(86.04±7.25)mmHg,差异无统计学意义(P>0.05)。非高血压组平均收缩压术前为(120.0±7.64)mmHg,术后1年时为(123.92±12.4)mmHg;平均舒张压术前为(75.0±5.4)mmHg,术后1年时为(76.8±7.48)mmHg,差异均无统计学意义(P>0.05)。结论后腹腔镜肾囊肿去顶术后患者术后3个月时收缩压及舒张压均较术前明显下降,术后1年时均恢复到术前水平;对于高血压患者,手术可能导致收缩压下降;患者的血压变化可能与肾素血管紧张素醛固酮系统的变化有关。Objective To investigate the effect of unilateral retroperitoneal laparoscopic renal cyst unroofing on blood pressure（BP）changes prospectively.Methods Between September 2014 and October 2015,52 patients were recruited who were diagnosed as renal cyst and received unilateral retroperitoneal laparoscopic renal cyst unroofing.We collected the data of the patients including blood pressure and level of serum renin angiotensin aldosterone before the surgery,and at the 3 rd,6 th,12 th month after procedure.Then all the data were analyzed to investigate the change in blood pressure and the level of serum renin angiotensin aldosterone between pre-and post-surgery.Results The average systolic BP values of patients were 131.25±15.37 mmHg,123.96±9.76 mmHg,130.04±11.63 mmHg,130.50±13.96 mmHg,before procedure,at the 3 rd,6 th,and 12 th month after procedure respectively;while average diastolic BP was 81.79±9.66 mmHg,73.56±6.52 mmHg,81.63±8.50 mmHg,81.60±8.65 mmHg at the corresponding time point.The average BP decreased significantly at 3 rd month after procedure,compared to preoperative level（P〈0.05）.But no significant difference of BP was observed at 6 th month and 12 th month after surgery,compared with preoperative level（P〉0.05）.And the level of average serum renin angiotensin aldosterone decreased significantly at 3 rd month after procedure（P〈0.05）,consistent with the change of BP.Then based on diagnosis before surgery,all the patients were divided into two groups as patients with hypertension and no hypertension group.In hypertension group,average systolic BP was 141.67±13.23 mmHg before the surgery and 136.59±12.63 mmHg at 12 th month after surgery,the difference was statistically significant.Average diastolic BP was 88.07±8.4 mmHg before surgery and 86.04±7.25 mmHg at 12 th month after surgery,no significant difference was observed（P〉0.05）.In no hypertension group,neither the difference in average systolic BP（123.92±12.4 mmHg）nor average diastolic BP（76.8±7.48 mmHg）at 12

关 键 词：肾囊肿 后腹腔镜肾囊肿去顶术 血压 肾素血管紧张素醛固酮系统 

分 类 号：R692.12[医药卫生—泌尿科学]