直径-轴距-极距肾肿瘤评分在腹腔镜肾部分切除术中的临床应用  

Clinical application of diameter-axial-polar renal tumor score in laparoscopic partial nephrectomy

作　　者：王磊[1] 马玲[2] 葛玉坤 乔庆东[1] 李龚龙[1] 冀阳[2] 李俊鹏 WANG Lei;MA Ling;GE Yukun;QIAO Qingdong;LI Gonglong;JI Yang;LI Junpeng(Department of the First Urologic Surgery,the Central Hospital of Xinxiang,Xinxiang 453000,Henan Province,China;Department of the Second Urologic Surgery,the Central Hospital of Xinxiang,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡市中心医院泌尿外一科,河南新乡453000 [2]新乡市中心医院泌尿外二科,河南新乡453000

出　　处：《新乡医学院学报》2020年第2期165-169,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨直径-轴距-极距(DAP)肾肿瘤评分在腹腔镜肾部分切除术中的应用价值。方法回顾性分析新乡市中心医院2013年1月至2019年8月收治的68例行腹腔镜肾部分切除术的单发肾肿瘤患者临床资料,分析DAP肾肿瘤评分与手术时间、肾脏热缺血时间、术中出血量、术后血红蛋白下降值、术后住院时间、围术期并发症及术后肾功能变化的关系。按照DAP肾肿瘤评分将患者分为低分值组38例(3~4分)、中分值组19例(5~6分)、高分值组11例(7~9分),比较3组患者临床特征的差异。结果 DAP评分与患者手术时间、热缺血时间、术中出血量、血红蛋白下降值、术后1 d血肌酐水平、术后1 d肾小球滤过率估计值(eGFR)、术后住院时间相关(P <0. 05),与患者年龄、性别、体质量指数(BMI)、术前血肌酐水平、术前eGFR及围术期并发症无关(P> 0. 05)。低分值组、中分值组和高分值组患者的性别、年龄、BMI、术前血肌酐水平、术前eGFR、术后住院时间及围术期并发症发生率比较差异均无统计学意义(P>0.05)。高分值组患者手术时间长于低分值组和中分值组(P <0.05);低分值组和中分值组患者手术时间比较差异无统计学意义(P>0.05)。中分值组和高分值组患者热缺血时间长于低分值组(P <0. 05),中分值组和高分值组患者热缺血时间比较差异无统计学意义(P> 0. 05)。高分值组患者术中出血量多于低分值组(P <0. 05),中分值组患者术中出血量与低分值组、高分值组比较差异均无统计学意义(P> 0. 05)。高分值组患者术后血红蛋白下降值高于低分值组(P <0. 05),中分值组患者术后血红蛋白下降值与低分值组、高分值组比较差异均无统计学意义(P> 0. 05)。高分值组患者术后1 d血肌酐水平和术后1 d eGFR高于低分值组和中分值组(P <0. 05);低分值组和中分值组患者术后1 d血肌酐水平和术后1 d eGFR比较差异无统计学意义(P> 0. 05)�Objective To investigate the clinical application of diameter-axial-polar(DAP) renal tumor score in laparoscopic partial nephrectomy. Methods The clinical data of 68 patients with single renal tumors who underwent laparoscopic partial nephrectomy in the Central Hospital of Xinxiang from January 2013 to August 2019 were analyzed retrospectively. The relationship between DAP renal tumor score and operation time,renal warm ischemia time,intraoperative blood loss,postoperative hemoglobin reduction value and postoperative hospital stay,perioperative complications and postoperative renal function were analyzed. The patients were divided into low score group(n = 38,3-4 scores),medium score group(n = 19,5-6 scores) and high score group(n = 11,2-9 scores) according to the DAP renal tumor score and the differences of clinical data of patients in the three groups were compared and analyzed. Results DAP renal tumor score was correlated with operation time,warm ischemia time,intraoperative blood loss,hemoglobin reduction value,serum creatinine level,estimated glomerular filtration rate(eGFR) at one day after operation and hospitalization time after operation(P < 0. 05);but it was not correlated with the age,gender,body mass index(BMI),serum creatinine level before operation,eGFR before operation and perioperative complications(P > 0. 05). There was no significant difference in the gender,age,BMI,preoperative serum creatinine level,preoperative eGFR,postoperative hospital stay and perioperative complications between the low score group,middle score group and high score group(P > 0. 05). The operation time of patients in the high score group was longer than that in the low score group and middle score group(P < 0. 05),there was no significant difference in the operation time of patients between the low score group and middle score group(P > 0. 05). The warm ischemia time of patients in the high score group and middle score group was longer than that in the low score group(P < 0. 05),there was no significant difference in the wa

关 键 词：直径-轴距-极距肾肿瘤评分 腹腔镜 肾部分切除术 肾肿瘤 

分 类 号：R737.11[医药卫生—肿瘤]