腹腔镜肾部分切除术后影响早期肾功能变化因素分析  

Related factors of early renal function changes after laparoscopic partial nephrectomy

作　　者：梁磊[1] 王毓斌 邵晋凯 LIANG Lei;WANG Yubin;SHAO Jinkai(Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学,太原030000 [2]山西医科大学附属人民医院泌尿外科,太原030000

出　　处：《实用医学杂志》2019年第10期1581-1585,共5页The Journal of Practical Medicine

基　　金：中国博士后科学基金(编号:2018M631771);山西省自然科学基金(编号:201701D121160)

摘　　要：目的分析肾肿瘤患者行后腹腔镜下肾部分切除术(LRN)后影响早期肾功能变化的相关因素。方法回顾性分析2016年6月至2018年6月行后腹腔镜下肾部分切除术的63例患者的临床资料,采用99mTc-DTPA肾核素扫描评估术前及术后3个月双侧肾脏的肾小球滤过率(GFR),收集患者年龄、性别、BMI、热缺血时间(WIT)、手术时间、R.E.N.A.L评分、病理类型、伴随疾病(高血压、糖尿病)、术中出血量、肿瘤部位、血肌酐,分析差异,并进行多因素回归分析。结果单因素分析结果显示,术后患肾GFR变化与年龄、高血压、BMI、R.E.N.A.L评分、WIT、术前患肾GFR水平等因素有相关性(P <0.05),多元线性回归结果显示,术后患肾GFR变化与年龄、R.E.N.A.L评分、WIT、术前患肾GFR水平等因素有相关性(P <0.05)。结论年龄、WIT、R.E.N.A.L评分、术前患肾GFR水平是影响患者后腹腔镜下肾部分切除术后肾功能恢复的危险因子。Objective Analysis of related factors that affect early renal function after retroperitoneal laparoscopic partial nephrectomy in patients with renal tumor. Methods The clinical data of 63 patients who underwent retroperitoneal laparoscopic partial nephrectomy from June 2016 to June 2018 were retrospectively analyzed. Glomerular filtration rate( GFR) of the renal units with tumor was measured by from 99m Tc-Diethylenetet-ramine pentaacetic acid( 99m Tc-DTPA) renal scan preoperatively and 3 months postoperatively. Age,sex,body mass index(BMI), warm ischemia time(WIT), operation time,R .E.N.A.L score,pathological type,accompanying diseases(hypertension,diabetes), intraoperative blood loss,tumor location and serum creatinine were collected. The single factor analysis used t test,Multivariate linear regression analysis was used for multivariate analysis. Results The results of univariate analysis showed that Changes of Postoperative GFR in diseased kidneys were correlated with age,hypertension,B MI,R .E.N.A.L score,WIT and preoperative GFR level,and the difference was statistically significant(P < 0.05). The results of multiple linear regression showed that the changes of Postoperative GFR were correlated with age,R.E.N.A.L score,W IT and preoperative GFR level,and the correlation was statistically significant(P < 0.05). Conclusions Age,W IT,R .E.N.A.L score and preoperative GFR in diseased kidneys were risk factors for renal function recovery after retroperitoneal laparoscopic partial nephrectomy.

关 键 词：肾肿瘤 腹腔镜肾部分切除术 肾功能 热缺血时间 

分 类 号：R737.11[医药卫生—肿瘤]