肾肿瘤肾部分切除术中肾动脉不同阻断方式的疗效分析  

Curative effect analysis of partial nephrectomy with different occlusion methods of renal artery in the treatment of renal tumors

作　　者：荣禄 丁德刚 刘建军 郝建伟 杜涛 王向阳 RONG Lu;DING De-gang;LIU Jian-jun(Department of Urology,the People’s Hospital of Henan Province,People’s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院,郑州大学人民医院泌尿外科,河南郑州450003

出　　处：《腹腔镜外科杂志》2021年第9期691-694,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹膜后腹腔镜局限性肾肿瘤肾部分切除术中肾动脉不同阻断方式的有效性及安全性。方法:回顾分析2019年7月至2020年7月收治的62例肾肿瘤患者的临床资料,患者分别采用高选择性肾动脉阻断(A组)与肾动脉全阻断(B组),比较两组手术时间、术中出血量、肾动脉阻断时间、住院时间及手术前后患者血肌酐、尿素氮、肾小球滤过率等指标。结果:两组手术均顺利完成,无中转开放。两组患者临床资料差异无统计学意义(P>0.05)。A组手术时间、肾动脉阻断时间长于B组,术中出血量多于B组(P<0.05);两组术后住院时间及术前血肌酐、尿素氮、肾小球滤过率差异均无统计学意义(P>0.05)。术后1个月复查,A组血肌酐、尿素氮低于B组,肾小球滤过率高于B组,差异均有统计学意义(P<0.05)。结论:对于局限性单发肾肿瘤,腹膜后腹腔镜高选择性肾动脉阻断肾部分切除术虽然手术时间、术中出血量有所增加,但利于术后肾功能的恢复。Objective:To investigate the efficacy and safety of retroperitoneal laparoscopic partial nephrectomy with different renal artery occlusion in the treatment of localized renal tumors.Methods:The clinical data of 62 patients with renal tumor from Jul.2019 to Jul.2020 were retrospectively analyzed.Patients were divided into group A(highly selective renal artery blocking)and group B(blocking of the main renal artery).The operation time,intraoperative blood loss,renal artery blocking time,hospital stay,preoperative and postoperative blood creatinine,urea nitrogen,and glomerular filtration rate were compared between the two groups.Results:All 62 patients in both groups were successfully operated without conversion to open operation.There was no statistically significant difference in baseline data between the two groups(P>0.05).The operation time and renal artery blocking time in group A were significantly longer than those in group B,and the intraoperative blood loss was significantly more than that in group B,the differences were statistically significant(P<0.05).There was no significant difference in the postoperative hospital stay,preoperative blood creatinine value,urea nitrogen,and glomerular filtration rate(P>0.05).Re-examination at 1 month after surgery showed that the blood creatinine and urea nitrogen of group A were lower than those of group B,and the glomerular filtration rate was significantly higher than that of group B,the differences were statistically significant(P<0.05).Conclusions:For localized single renal tumor,retroperitoneal laparoscopic partial nephrectomy with highly selective artery blocking is beneficial to the recovery of postoperative renal function,although the operative time is prolonged and the intraoperative blood loss is increased.

关 键 词：肾肿瘤 肾部分切除术 腹腔镜检查 腹膜后路径 高选择性肾动脉阻断 

分 类 号：R737.11[医药卫生—肿瘤]