经后腹腔入路腹腔镜手术与开放性肾癌根治术对肾癌患者肾功能及预后的影响  

Effects of Retroperitoneal Laparoscopic Surgery and Open Radical Nephrectomy on Renal Function and Prognosis in Patients with Renal Carcinoma

作　　者：黄强[1] 冯振华[1] 彭业平[1] 陈先国[1] HUANG Qiang;FENG Zhenhua;PENG Yeping;CHEN Xianguo(The People’s Hospital of Gaozhou,Gaozhou 525200,China)

机构地区：[1]广东省高州市人民医院,广东高州525200

出　　处：《中国医学创新》2020年第6期17-21,共5页Medical Innovation of China

摘　　要：目的:分析经后腹腔入路腹腔镜手术与开放性肾癌根治术对肾癌患者肾功能及预后的影响。方法:选取2014年1月-2016年12月本院收治的82例肾癌患者,根据随机数x表法分为观察组和对照组,每组41例。观察组给予经后腹腔入路腹腔镜手术治疗,对照组给予开放性肾癌根治术治疗。比较两组手术指标、生存率、并发症发生率及手术前后肾功能和炎性指标水平。结果:观察组手术时间、胃肠功能恢复时间、住院时间均明显短于对照组,术中出血量和术后引流量均明显少于对照组,差异均有统计学意义(P<0.05);术后2个月,两组Cr、BUN、β2-MG水平均显著高于术前,但观察组Cr、BUN、β2-MG水平均低于对照组,差异均有统计学意义(P<0.05);术后1个月,两组CRP、IL-6水平均显著高于术前,但观察组CRP、IL-6水平均低于对照组,差异均有统计学意义(P<0.05);术后观察组并发症发生率为7.32%,显著低于对照组的24.39%,差异有统计学意义(P<0.05);术后1年,两组生存率比较,差异无统计学意义(P>0.05);术后3年,观察组生存率高于对照组,差异有统计学意义(P<0.05)。结论:经后腹腔入路腹腔镜手术治疗肾癌可减轻损伤,对肾功能的影响较小,减少并发症的发生,提高手术的安全性和生存率,加速术后恢复,建议在临床上推广。Objective:To analyze the effects of retroperitoneal laparoscopic surgery and open radical nephrectomy on renal function and prognosis in patients with renal cancer.Method:A total of 82 cases of renal carcinoma admitted to our hospital from January 2014 to December 2016 were selected.According to the random number table method,they were divided into observation group and control group,41 cases in each group.The observation group was treated with laparoscopic surgery via retroperitoneal approach,the control group was treated with open radical nephrectomy.The indexes of operation,survival rate,complication rate,renal function and inflammatory index before and after operation were compared between the two groups.Result:The operation time,gastrointestinal function recovery time and hospitalization time of patients in the observation group were significantly shorter than those in the control group,intraoperative blood loss and postoperative drainage volume were significantly lower than those in the control group,the differences were statistically significant (P<0.05).2 months after surgery,the levels of Cr,BUN and β2-MG in both groups were significantly higher than those before surgery,however,the levels of Cr,BUN and β2-MG in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).1 month after surgery,CRP and IL-6 levels in both groups were significantly higher than those before surgery,however,CRP and IL-6 levels in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).The complication rate of postoperative observation group was 7.32%,significantly lower than the 24.39% of the control group,the difference was statistically significant (P<0.05).1 year after surgery,survival rates were compared between the two groups,the difference was not statistically significant (P>0.05).3 years after surgery,the survival rate of the observation group was higher than that of the control group,the dif

关 键 词：后腹腔入路 肾癌根治术 肾功能 预后 

分 类 号：R737.11[医药卫生—肿瘤]