后腹腔镜肾部分切除术中热缺血时间对肾肿瘤患者肾功能及并发症的影响  

Effect of warm ischemia time on renal function and complication in patients with renal tumors during retroperitoneal laparoscopic partial nephrectomy

作　　者：卢灿峰[1] 刘刚[1] 窦中岭[1] LU Canfeng;LIU Gang;DOU Zhongling(Department of Urology,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,He’nan,China)

机构地区：[1]河南科技大学第一附属医院泌尿外科,河南洛阳471000

出　　处：《癌症进展》2021年第23期2440-2442,2460,共4页Oncology Progress

摘　　要：目的观察热缺血时间(WIT)对后腹腔镜肾部分切除术(RLPN)患者术后肾功能及并发症的影响。方法将90例行RLPN患者按WIT分为WIT≤30 min组68例和WIT﹥30 min组22例。观察两组患者手术前、术后1个月的肾功能,手术前、术后3天的内皮功能、炎症因子水平,术后3个月内并发症发生情况的差异。结果手术前,两组患者血清肌酐(Scr)、尿素氮(BUN)、总肾肾小球滤过率(GFR)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、一氧化氮(NO)、内皮素1(ET-1)、血管性血友病因子(vWF)水平比较,差异均无统计学意义(P﹥0.05);术后1个月,WIT﹥30 min组患者总肾GFR水平低于WIT≤30 min组,差异有统计学意义(P﹤0.05);术后3天,WIT﹥30 min组患者IL-10、IL-6、CRP、NO、vWF水平均高于WIT≤30 min组,ET-1水平低于WIT≤30 min组,差异均有统计学意义(P﹤0.05)。WIT﹥30 min组患者并发症总发生率明显高于WIT≤30 min组患者,差异有统计学意义(P﹤0.01)。结论WIT会影响RLPN患者术后肾功能及并发症,其中WIT﹥30 min对患者的影响较大。Objective To observe the effect of warm ischemia time(WIT)on renal function and complication of patients after retroperitoneal laparoscopic partial nephrectomy(RLPN).Method A total of 90 patients who underwent RLPN were divided into the WIT≤30 min group(n=68)and WIT>30 min group(n=22)according to intraoperative WIT.the renal function before and 1 month after the operation,the endothelial function and inflammatory factor levels before and 3 days after operation,and complications 3 months after operation were observed.Result There were no significant differences for the serum creatinine(Scr),blood urea nitrogen(BUN),total renal glomerular filtration rate(GFR),interleukin-10(IL-10),interleukin-6(IL-6),C-reactive protein(CRP),nitric oxide(NO),endothelin-1(ET-1),von Willebrand factor(vWF)between the two groups before surgery(P>0.05).1 month after surgery,the total renal GFR level of the WIT>30 min group was lower than that of the WIT≤30 min group(P<0.05).3 days after surgery,the levels of IL-10,IL-6,CRP,NO and vWF in the WIT>30 min group were higher,the ET-1 lower than those in the WIT≤30 min group(P<0.05);the incidence of complications in the WIT>30 min group was higher than that of the WIT≤30 min group(P<0.01).Conclusion WIT can influence the renal function and complication of patients undergoing RLPN,which has greater impact on patients with WIT>30 min.

关 键 词：热缺血时间 腹腔镜 肾部分切除 内皮功能 炎症因子 

分 类 号：R737.11[医药卫生—肿瘤]