后腹腔镜肾切除术与开放手术对肾结核的疗效及安全性的对比分析  

Efficacy and safety analysis of retroperitoneal laparoscopic nephrectomy and open surgery in treatment of renal tuberculosis

作　　者：高雪松[1] 贾卓敏[1] 王毅[1] 赵豫波[1] 王希友[1] 沈诞[1] 徐衍盛[1] Gao Xuesong;Jia Zhuomin;Wang Yi;Zhao Yubo;Wang Xiyou;Shen Dan;Xu Yansheng(Department of Urology and Clinical Medicine,Third Medical Center,Chinese People's Liberation Army General Hospital,Beijing 100048,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,北京100048

出　　处：《海军医学杂志》2022年第6期626-630,共5页Journal of Navy Medicine

摘　　要：目的对比后腹腔镜肾切除术与开放手术治疗肾结核的疗效及安全性。方法将2015年7月至2020年6月在解放军总医院第三医学中心泌尿外科接受后腹腔镜肾切除术治疗与接受传统开放手术治疗的肾结核患者作为研究对象,分为观察组和对照组,各18例。比较2组患者的临床资料、总有效率、手术情况、术后留置尿管时间、住院时间、术后疼痛评分、术后炎性因子指标、术后并发症发生率、生活质量评分、术后复发率。结果观察组总有效率均达到100.00%,对照组总有效率为88.89%。观察组的手术时间长于对照组(P<0.05),但观察组的术中出血量少于对照组(P<0.05)。观察组的术后留置尿管时间、住院时间均短于对照组(P<0.05)。术后第1~3天,观察组的疼痛评分、C反应蛋白水平、白细胞介素⁃6水平相比于对照组均更低(P<0.05)。观察组无术后并发症,对照组并发症发生率为22.2%,观察组低于对照组(P<0.05)。与治疗前相比,2组患者治疗后的生活质量评分均增高(P<0.05)。治疗后,观察组的生活质量评分高于对照组(P<0.05)。术后随访6个月、12个月,观察组与对照组的复发率比较,差异无统计学意义(P>0.05)。结论后腹腔镜肾切除术用于治疗肾结核与传统开腹手术治疗效果无差异,均能对患者病情进行有效控制,并在减轻术后疼痛感、减少术后炎性因子渗出、降低术后并发症风险、加快术后康复进展、提高生活质量水平方面效果更显著。Objective To compare the efficacy and safety of retroperitoneal laparoscopic nephrectomy and open surgery in treatment of renal tuberculosis.Methods The patients with renal tuberculosis who underwent retroperitoneal laparoscopic nephrecto⁃my and traditional open surgery repectively in the Urology Department of the Third Medical Center of the Chinese People’s Liberation Army General Hospital from July 2015 to June 2020 were selected as esearch subjects,and were divided into the observation group and the control group,each consistimg of 18 patients.The clinical data,total effective rate,surgical status,postoperative indwelling catheter time,length of hospital stay,postoperative pain scores,postoperative inflammatory factor indexes,postoperative complication rate,quality of life scores,rate of postoperative recurrence were compared between the two groups.Results The total effective rate of the observation group was 100.00%,while that of the control group was 88.89%.The surgical time of the observation group was lon⁃ger than that of the control group(P<0.05),but the surgical blood loss of the observation group was less than that of the control group(P<0.05).The postoperative indwelling catheter time and length of hospital stay in the observation group were all shorter than those in the control group(P<0.05).On the 1st to 3rd day after surgery,the pain scores,C⁃reactive protein and interleukin⁃6 of the observation group were all lower than those of the control group(P<0.05).There was no postoperative complications in the observation group,as compared with the rate of 22.2%in the control group,with the observation group being lower than the control group(P<0.05).Com⁃pared with that before treatment,the quality of life scores in the patients of the two groups after treatment all improved,with the quality of life scores of the observation group being higher than those of the control group(P<0.05).6⁃months and 12⁃months medical follow⁃ups after surgery indicated that there was no significant difference i

关 键 词：肾结核 传统开放手术 后腹腔镜肾切除术 

分 类 号：R692[医药卫生—泌尿科学]