改良及传统后腹腔肾蒂淋巴管结扎术治疗乳糜尿临床效果比较  

Comparison of clinical effects between modified and conventional retroperitoneal laparoscopic renal pedicle lymphatic ligation in the treatment of chyluria

作　　者：寇国义 李华桥 杨奎 李明富 KOU Guo-yi;LI Hua-qiao;YANG Kui;LI Ming-fu(The First Department of Surgery,Changning Hospital,Changning 644300,Sichuan,China)

机构地区：[1]四川省长宁县中医医院外一科

出　　处：《实用医院临床杂志》2019年第5期248-251,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察改良及传统后腹腔肾蒂淋巴管结扎术治疗乳糜尿的临床疗效及术后并发症。方法回顾性分析52例乳糜尿患者的临床资料,根据手术治疗方式分为改良后腹腔镜肾蒂淋巴管结扎术(观察组)和传统后腹腔肾蒂淋巴管结扎术(对照组)各26例,比较两组手术时间,术中出血量,术后卧床时间及住院时间,术后第1、3天VAS疼痛评分及治疗前后肾小球滤过率、血红蛋白及血清白蛋白变化情况和术后并发症发生情况。结果观察组手术时间,术中出血量,术后卧床时间及住院时间,术后第1、3天VAS评分,并发症发生率均低于对照组(P<0.05)。两组治疗后肾小球滤过率较治疗前降低(P<0.05),但组间比较差异无统计学意义(P>0.05),血红蛋白、血清白蛋白在治疗前后差异无统计学意义(P>0.05)。结论改良后腹腔肾蒂淋巴管结扎术治疗乳糜尿具有创伤小、缩短手术时间和住院时间、术后恢复快、肾脏损伤小及术后并发症少等优点,治疗效果优于传统术式。Objective To observe the clinical efficacy and postoperative complications of modified and conventional retroperitoneal laparoscopic renal pedicle lymphatic ligation in the treatment of chyluria.Methods Clinical data of 52 patients with chyluria were retrospectively analyzed.The patients were divided into observation group treated with the modified laparoscopic renal pedicle lymphatic ligation and control group treated with traditional posterior abdominal renal pedicle lymphatic ligation,26 in each group according to different surgical method.The operative time,intraoperative blood loss,postoperative bed rest time and postoperative hospital stay,VAS pain scores on the first and third day after operation,changes of glomerular filtration rate,hemoglobin and serum albumin before and after treatment as well as postoperative complications were compared between the two groups.Results The time of operation,amount of intraoperative blood loss,postoperative bed rest time,postoperative hospital stays,VAS score on the 1^st and 3^rd day after operation and incidence rate of complications in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the glomerular filtration rate of the two groups was significantly lower than that before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant change in hemoglobin and serum albumin before and after treatment(P>0.05)..Conclusion The modified retroperitoneal laparoscopic renal pedicle lymphatic ligation has the advantages of fewer traumas,shorter operative time and hospital stays,rapider postoperative recovery,smaller renal injury and less postoperative complications in the treatment of chyluria.Therefore,its clinical efficacy is better than that of traditional surgical method.

关 键 词：改良 后腹腔肾蒂淋巴管结扎术 乳糜尿 疗效 

分 类 号：R699.2[医药卫生—泌尿科学]