解剖性后腹腔镜切除术治疗肾上腺肿瘤患者56例临床疗效观察  

Clinical effect observation of anatomical retroperitoneoscopic adrenalectomy in 56 patients with adrenal tumors

作　　者：高雪松[1] 贾卓敏[1] 王毅[1] 赵豫波[1] 王希友[1] 徐衍盛[1] 沈诞[1] Xuesong Gao;Zhuomin Jia;Yi Wang;Yubo Zhao;Xiyou Wang;Yansheng Xu;Dan Shen(Faulty of Clinical Medicine,Department of Urology,The Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心泌尿外科临床医学部,北京100039

出　　处：《中华航海医学与高气压医学杂志》2022年第3期384-388,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：国家自然科学基金资助项目(81502200)。

摘　　要：目的:探讨解剖性后腹腔镜切除术在肾上腺肿瘤患者治疗中的应用效果。方法:选取2016年1月至2021年1月解放军总医院第三医学中心泌尿外科收治的肾上腺肿瘤患者112例作为研究对象,按照双盲法将患者随机分为对照组和研究组,每组56例。对照组患者采用经腹入路腹腔镜治疗,研究组患者则采用解剖性后腹腔镜治疗,比较2种手术方式术后临床指标的变化;采用酶联免疫吸附实验检测患者术前和术后6 h血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)等炎性因子水平;采用美国Medica电解质分析仪检测患者血清Na+和K+及HCO^(-)_(3)水平;同时观察患者预后及并发症发生情况。结果:研究组手术时间、引流管放置时间、胃肠功能恢复时间和住院时间均短于对照组,差异有统计学意义(P<0.05或P<0.01)。研究组术后血清IL-6、IL-1β、hs-CRP水平明显低于对照组,Na+、HCO^(-)_(3)水平低于对照组,K+水平则高于对照组,差异均有统计学意义(P<0.05或P<0.01)。研究组术后并发症发生率[14.29%(8/56)]明显低于对照组[14.29%(8/56)],差异有统计学意义(χ^(2)=3.953,P=0.047)。术后随访6个月2组患者均未出现复发或转移。结论:解剖性后腹腔镜切除术治疗肾上腺肿瘤能够更好地减轻手术对患者造成的创伤,减少对患者内环境的影响,有效促进其术后康复进程,且具有更高的安全性。Objective To investigate the applicable effect of anatomical retroperitoneoscopic adrenalectomy in treating patients with adrenal tumors.Methods A total of 112 patients with adrenal tumors admitted to the Department of urology of The Third Medical Center of Chinese PLA General Hospital from January 2016 to January 2021 were selected as research subjects,and they were divided into control group and study group according to the double-blind method,with 56 cases in each group.The patients in the control group were treated with laparoscopic transabdominal adrenalectomy,while the patients in the study group were treated with anatomical retroperitoneoscopic adrenalectomy.The clinical indicators of the two surgical methods were compared.Before and six hours after surgery,the serum levels of inflammatory factors including interleukin-6(IL-6),interleukin-1β(IL-1β),and hypersensitive C-reactive protein(hs-CRP)were detected by enzyme-linked immunosorbent assay(ELISA),and the electrolytes such as Na+,K+,and bicarbonate(HCO-3)were detected by the America-made Medica electrolyte analyzer.The prognosis and incidence of complications in the two groups were observed.Results Compared with the control group,the time spent in operation,the time spent for drainage tube placement and gastrointestinal function recovery,and hospital stay were all shorter in the study group(P<0.05 or P<0.01).After surgery,the serum levels of IL-6,IL-1β,and hs-CRP in the study group were significantly lower than those in the control group,and the levels of Na+and HCO-3 in the study group were also lower than those in the control group,while the K+level was higher than that in the control group,all with statistically significant differences(P<0.05 or P<0.01).The incidence of complications in the study group[3.57%(2/56)]was significantly lower than that in the control group[(14.29%(8/56)],with statistically significant difference(P<0.05).No recurrence or metastasis occurred in the two groups during the six-month follow-up after surgery.Conclusion Anatomi

关 键 词：肾上腺肿瘤 解剖性后腹腔镜切除术 炎性因子 电解质 并发症 

分 类 号：R736.6[医药卫生—肿瘤]