DAP评分系统对T1期肾肿瘤患者病情评估及手术方式选择的意义  

DAP Scoring System in Evaluation of T1 Renal Tumor and Guidance to Surgical Procedures

作　　者：戚敏俊[1] 吴小鹏[1] 周忠兴[1] 蒋晓东[1] 左立[1] QI Ming-jun;WU Xiao-peng;ZHOU Zhong-xin(Changzhou Second People's Hospital,Jiangsu Province 213000)

机构地区：[1]江苏省常州市第二人民医院泌尿外科,江苏常州213000

出　　处：《医学临床研究》2019年第11期2166-2169,共4页Journal of Clinical Research

摘　　要：【目的】评价DAP评分系统对T1期肾肿瘤患者病情评估及对其手术方式选择的指导性价值。【方法】随机抽选本院收治的92例T1期肾肿瘤患者资料展开回顾性分析。以DAP评分系统为标准,将92例患者分为3组:低分组18例、中分组47例、高分组27例。比较三组的手术方式、手术指标参数及并发症发生的相关性。【结果】行开放手术:低分组3例、中分组27例、高分组8例,腹腔镜下手术:低13例、中6例、高1例,根治性肾切除术:低1例、中15例、高18例,三组患者的主要手术方式相比较差异有显著性(P<0.05)。DAP评分系统与手术方式、操作时长、热缺血时长、预估出血量存在相关性(P<0.05);与住院时间、肾小球滤过率无相关性(P>0.05)。并发症的发生与年龄、体质指数、发病部位、热缺血时长无相关性(P>0.05);与手术方式、操作时长、出血量、DAP系统评分存在相关性(P<0.05)。【结论】临床对T1期肾肿瘤患者应用DAP评分系统,可指导治疗方式的选择,对临床预测围手术期结局具有很好的指导意义。【Objective】To evaluate the DAP scoring system in T1 stage of renal tumor and selection of surgical methods.【Methods】Data of 92 patients with T1 stage of renal tumor admitted to our hospital were randomly selected for retrospective analysis.According to the DAP scoring system,92 patients were divided into 3 groups:the low score group(n=18),the medium score group(n=47)and the high score group(n=27).The correlation of surgical methods,surgical parameters and complications were compared among the three groups.【Results】Data showed that 3 cases in the low score group,27 cases in the medium score group and 8 cases in the high score group received open surgery;13 cases in the low score group,6 cases in the medium score group and 1 case in the high score group had laparoscopic surgery;1 case in the low score group,15 cases in the medium score group and 18 cases in the high score group had radical nephrectomy.There were differences between surgical selections and DAP scores(P<0.05).The DAP scoring system was correlated with surgical approach,duration of operation,duration of warm ischemia and estimated blood loss(P<0.05).It was not correlated with the length of hospital stay or glomerular filtration rate(P>0.05).The incidence of complications was not related to age,body mass index,location of onset and duration of warm ischemia(P>0.05).It was correlated with operation mode,operation duration,blood loss and DAP system score(P<0.05).【Conclusion】The clinical application of DAP scoring system in patients with T1 renal tumor is helpful for the selection of clinical treatment methods and valuable for clinical prediction of perioperative outcomes.

关 键 词：肾肿瘤/外科学 肾肿瘤/方法 手术 

分 类 号：R737.ll[医药卫生—肿瘤]