腹腔镜肾部分切除术不同缝合成型方法对复杂性肾肿瘤患者细胞因子及临床效果的影响  

Effect of different types of suture used in laparoscopic partial nephrectomy on various cytokines and clinical effects in patients with complicated renal cell carcinoma

作　　者：周昌东[1] 田玉新[1] 林洋[1] 张奇夫 ZHOU Changdong;TIAN Yuxin;LIN Yang;ZHANG Qifu(Department of Urological Surgery,Jilin Tumor Hospital,Changchun 130012,Jilin,China)

机构地区：[1]吉林省肿瘤医院泌尿外科,长春130012

出　　处：《癌症进展》2018年第13期1634-1636,1679,共4页Oncology Progress

摘　　要：目的探讨两种缝合成型方法在腹腔镜肾部分切除术治疗复杂性肾肿瘤患者中的临床效果及对细胞因子的影响。方法选择复杂性肾肿瘤患者78例,按随机数字表法分为对照组和观察组,各39例。两组患者均采用腹腔镜肾部分切除术治疗,对照组采用常规方法缝合成型,观察组采用倒刺缝合成型,采用酶联免疫吸附试验测定两组治疗不同时间点白细胞介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平,并比较临床疗效及细胞因子水平。结果两组患者手术时间、切缘宽度比较,差异均无统计学意义(P>0.05);观察组患者热缺血时间(WIT)明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.01)。手术前两组患者IL-6、CRP及TNF-α水平比较,差异均无统计学意义(P>0.05);手术后观察组患者IL-6、CRP及TNF-α水平均明显低于对照组,差异均有统计学意义(P<0.01)。观察组患者术后并发症发生率为7.69%,低于对照组的30.77%,差异有统计学意义(P<0.05)。结论复杂性肾肿瘤患者腹腔镜肾部分切除术中采用倒刺缝合成型治疗效果理想,有助于改善细胞因子水平,值得推广应用。Objective To explore the clinical effects of two types of suture applied in laparoscopic partial nephrectomy for complicated renal cell carcinoma （RCC） and the effects on cytokines.Method 78 patients with complicated RCC were randomized as control group or study group, with 39 cases in each. Both groups of patients were treated with laparoscopic partial nephrectomy, while conventional suture and barbed suture were utilized in control group and study group, respectively. The enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of ituerleukin-6 （IL-6）, C-reactive protein （CRP） and tumor necrosis factor-α （TNF-α） at different time points, and the clinical efficacy and the levels of cytokines were compared. Result There was no significant difference in the operative time and excision margin between the two groups （P〉0.05）; the warm ischemia time （WIT） was significantly shorter, and intxaoperative blood loss was significantly less in study group tJma in control group, and the differences were statistically significant （P〈0.01）. There was no significant difference in the levels of IL-6, CRP and TNF-α between the two groups before surgery （P〉 0.05）; while the levels of IL-6, CRP and TNF-ct in study group after surgery were significantly lower titan those in control group, the differences were of statistical significance （P〈0.01）. The incidence of postoperative complications in study group was 7.69%, which was lower than that in control group at 30.77%, indicating statistically significant difference （P〈 0.05）.Conclusion The use of barbed suture in the treatment of complicated renal cell carcinoma during laparoscopic par- tial nephrectomy is ideal for improving the level of cytokines and is worthy of application in clinical practice.

关 键 词：常规方法缝合成型 倒刺缝合成型 腹腔镜肾部分切除术 复杂性肾肿瘤 临床效果 细胞因子 

分 类 号：R737.11[医药卫生—肿瘤]