后腹腔镜手术切除对比开放手术对巨大嗜铬细胞瘤的短期临床疗效  

Short-term clinical efficacy of retroperitoneal laparoscopic surgery versus open surgery for giant pheochromocytoma

作　　者：刘光伟 向彬 雷光辉 杨纬家 邓美荣 张亚龙 LIU Guangwei;XIANG Bin;LEI Guanghui;YANG Weijia;DENG Meirong;ZHANG Yalong(Department of Urology,Xidian Group Hospital,Xi'an 710077,China)

机构地区：[1]西电集团医院泌尿外科,西安710077

出　　处：《临床与病理杂志》2020年第12期3165-3170,共6页Journal of Clinical and Pathological Research

摘　　要：目的:探讨后腹腔镜手术切除术对比开放手术对巨大嗜络细胞瘤的临床效果,为患者诊疗提供依据。方法:抽取2012年1月至2017年1月期间在西电集团医院接诊的巨大嗜铬细胞瘤患者70例,采用随机数表法分为观察组(n=35)和对照组(n=35)。观察组给予腹腔镜手术治疗,对照组给予开放手术治疗。比较2组患者治疗效果,记录患者手术情况,比较术前、术后血浆皮质醇水平、生活质量评分变化,比较治疗期间2组并发症发生率。结果:治疗后,观察组总有效率(97.14%)高于对照组总有效率(85.71%),但差异无统计学意义(P>0.05);观察组术中出血量、术后疼痛评分均低于对照组(P<0.05);观察组术后胃肠功能恢复时间、术后拔管时间、术后住院时间,均短于对照组(P<0.05)。术后患者血浆皮质醇水平降低,且观察组高于对照组(P<0.05);观察组术前、术后血浆皮质醇水平差异无统计学意义(P>0.05)。术后,两组患者物质生活、躯体功能、心理功能等生活质量评分均有升高,且观察组均高于对照组(P<0.05);治疗期间患者均有出现心动过速、低血压、感染等并发症,观察组总发生率8.57%,明显低于对照组的28.57%(P<0.05)。结论:腹腔镜手术对机体的损伤小,术中出血少,减轻患者疼痛感受,促进患者术后胃肠功能恢复,对血浆皮质醇水平影响小,缩短患者住院时间,提高患者生活质量,安全性高,值得临床推广使用。Objective:To explore the short-term clinical efficacy of retroperitoneal laparoscopic surgery versus open surgery on giant pheochromocytoma,and provide a reference for clinical treatment.Methods:Seventy patients with giant pheochromocytoma who were admitted to our hospital from January 2012 to January 2017 were enrolled.The patients were divided into an observation group(n=35)and a control group(n=35)by random number table method.The observation group was treated with laparoscopic surgery and the control group was given open surgery.The therapeutic effects of the 2 groups were compared.The changes of plasma cortisol and quality of life scores were compared before and after surgery.The incidence of complications during the treatment was compared with the 2 groups.Results:After treatment,the total effective rate of the observation group(97.14%)was higher than the total effective rate of the control group(85.71%),but the difference was not statistically significant(P>0.05).The intraoperative blood loss/postoperative pain score of the observation group was lower than that of the control group(P<0.05).The recovery time of gastrointestinal function,postoperative extubation time,and postoperative hospital stay of the observation group was shorter than that of the control group(P<0.05).The levels of plasma cortisol decreased in the two groups after operation,but the observation group was higher than the control group(P<0.05).There was no difference in plasma cortisol expression between the observation group and the postoperative group(P>0.05).After operation,the quality of life,physical function,and mental function of the two groups were increased,and the observation group was higher than the control group(P<0.05).During the treatment period,both groups had tachycardia,hypotension,infection,and other complications.The total incidence of the observation group was 8.57%,which was significantly lower than the total incidence of complications in the control group(28.57%,P<0.05).Conclusion:Laparoscopic surgery has less damage

关 键 词：腹腔镜手术 嗜铬细胞瘤 疗效 生活质量 

分 类 号：R736.6[医药卫生—肿瘤]