无功能肾结核后腹腔镜肾切除术中转开放性手术的相关因素分析  

Analysis in related factors of patients with non-functional renal tuberculosis transferring from retroperitoneal laparoscopic nephrectomy to open surgery in intraoperation

作　　者：刘建华 崔振鹏 张礼军 李军孝 陈其亮 LIU Jianhua;CUI Zhenpeng;ZHANG Lijun;LI Junxiao;CHEN Qiliang(Shaanxi Provincial Tuberculosis Prevention and Control Hospital,Xi′an,Shaanxi,710100;The 521 st Hospital of Ordnance Industry,Xi′an,Shaanxi,710065;Minda Hospital Affiliated to Hubei University for Nationalities,Enshi,Hubei,445000)

机构地区：[1]陕西省结核病防治院,陕西西安710100 [2]兵器工业五二一医院,陕西西安710065 [3]湖北民族大学附属民大医院,湖北恩施445000

出　　处：《实用临床医药杂志》2020年第13期104-107,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨无功能肾结核后腹腔镜术中转开放性手术的相关因素。方法选取行后腹腔镜下肾切除术的93例无功能肾结核患者作为研究对象,将肾周围组织严重粘连而术中转为开放性手术的患者纳入研究组,将未中转开放性手术患者纳入对照组。对2组患者的年龄、性别、体质量指数(BMI)、合并糖尿病、合并高血压和切除肾脏的位置、大小、钙化情况、周围渗出情况、对侧肾积水情况、术前抗结核治疗时间进行对比分析。结果有21例患者术中转开放性手术,占22.58%。研究组患者的BMI、合并糖尿病比率、切除肾组织直径>10 cm比率、术前抗结核治疗时间≤3个月比率均高于对照组,差异有统计学意义(P<0.05或P<0.01)。Logistic多元回归分析结果显示,合并糖尿病、切除肾组织直径、术前抗结核治疗时间均与无功能肾结核后腹腔镜术中转开放性手术具有相关性(P<0.01)。结论无功能肾结核后腹腔镜术中转开放性手术与糖尿病、切除肾组织直径、术前抗结核治疗时间等因素有关,临床医生应针对相关因素进行全面评价与有效干预,提高腹腔镜手术的成功率,降低中转开放性手术的风险,减少手术创伤。Objective To explore the related factors of patients with non-functional renal tuberculosis transferring from retroperitoneal laparoscopic nephrectomy to open surgery in intraoperation.Methods A total of 93 patients with non-functional renal tuberculosis underwent retroperitoneal laparoscopic nephrectomy were selected as research objects.The patients transferring from retroperitoneal laparoscopic nephrectomy to open nephrectomy due to severe adhesion of the surrounding tissues of the resected kidney were selected as study group,and those without surgery conversion were included in control group.The age,gender,body mass index(BMI),complicating with diabetes mellitus as well as hypertension,position of kidney excision,size,calcification,peripheral exudation of the resected kidney as well as contralateral hydronephrosis,the duration of preoperative antituberculosis treatment in the two groups were compared and analyzed.Results Twenty-one patients were converted to open nephrectomy,accounting for 22.58%.The BMI,the ratio of complicating with diabetes mellitus,ratio of diameter of resected kidney above 10 cm,and the ratio of duration of preoperative antituberculosis treatment≤3 months in the study group were higher than those in the control group,the differences were statistically significant(P<0.05 or P<0.01).The results of Logistic multiple regression analysis showed that the conversion from retroperitoneal laparoscopic nephrectomy to open nephrectomy for non-functional renal tuberculosis was correlated with complicating with diabetes mellitus,the size of resected kidney,the duration of preoperative antituberculosis treatment(P<0.01).Conclusion The conversion from retroperitoneal laparoscopic nephrectomy to open nephrectomy for non-functional renal tuberculosis is related to diabetes mellitus,the size of resected kidney,the duration of preoperative antituberculosis treatment.The clinicians should comprehensively evaluate and effectively intervene the related factors to enhance the success rate of laparoscopic neph

关 键 词：无功能肾结核 后腹腔镜肾切除术 开放性肾切除术 相关因素 

分 类 号：R527.1[医药卫生—内科学]