层面外科解剖性后腹腔镜肾上腺切除术与开放性手术对肾上腺肿瘤患者的影响  

Effect of Horizontal Surgical Anatomical Retroperitoneoscopic Adrenalectomy and Open Surgery in Patients with Adrenal Tumors

作　　者：邵昶 邵萍 SHAO Chang;SHAO Ping(Wuxue First People’s Hospital,Wuxue 435400,China;不详)

机构地区：[1]武穴市第一人民医院,湖北武穴435400

出　　处：《中外医学研究》2022年第18期36-39,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:应用层面外科解剖性后腹腔镜肾上腺切除术(ARA)与开放性手术治疗后,对比两种手术对肾上腺肿瘤(AT)患者的疗效差异。方法:在2020年8月-2021年8月,选取武穴市第一人民医院收治的90例AT患者为探究对象,根据随机表法分为腹腔组与开放组。开放组(n=45)行开放手术治疗,腹腔组(n=45)行层面外科ARA治疗。对比两组手术效果、内分泌指标[皮质醇(Cor)、去甲上腺素(NE)、肾上腺素(E)]、白介素-6(IL-6)及中性粒细胞弹性蛋白酶。结果:治疗前,两组Cor、E、NE、IL-6及中性粒细胞弹性蛋白酶水平相较,差异无统计学意义(P>0.05);治疗后,两组Cor、E、NE较治疗前呈现显著降低趋势,IL-6、中性粒细胞弹性蛋白酶水平较治疗前均呈现明显增高趋势,且腹腔组患者的上述指标均优于开放组,差异有统计学意义(P<0.05)。与开放组比较,腹腔组患者的手术时间、住院时间更短,术中出血量更少,差异有统计学意义(P<0.05)。结论:层面外科ARA安全有效,对机体创伤小,对内分泌等各项指标的影响较小。Objective:To compare the curative effects of applied horizontal surgical anatomical retroperitoneoscopic adrenalectomy(ARA)and open surgical in patients with adrenal tumors(AT).Method:A total of 90 patients with AT admitted to Wuxue First People’s Hospital from August 2020 to August 2021 were selected as the inquiry subjects and divided into intraperitoneal group and open group according to the randomized table method.The open group(n=45)was treated with open surgery,and the intraperitoneal group(n=45)was treated with horizontal surgical ARA.The surgical effects,endocrine indexes[cortisol(Cor),norepinephrine(NE),epinephrine(E)],interleukin-6(IL-6)and polymorphonuclear neutrophil elastase of the two groups were compared.Result:Before treatment,the levels of Cor,E,NE,IL-6 and polymorphonuclear neutrophil elastase levels of the two groups were not significantly significant(P>0.05),after treatment,the levels of Cor,E and NE in the two groups were significantly lower than those before treatment,the levels of IL-6 and polymorphonuclear neutrophil elastase were significantly increased compared with before treatment,and the above indexes in the intraperitoneal group were better than those in the open group,the differences were statistically significant(P<0.05).Compared with the open group,the intraperitoneal group had shorter surgery time,hospitalization time and less intraoperative bleeding,the differences were statistically significant(P<0.05).Conclusion:Horizontal surgical ARA is safe and effective,with less trauma to the body,and less impact on endocrine and other indicators.

关 键 词：层面外科解剖性后腹腔镜肾上腺切除术 开放性手术 肾上腺肿瘤 内分泌 

分 类 号：R736.6[医药卫生—肿瘤]