后腹腔镜肾切除术治疗无功能肾积水的效果及对患者应激反应的影响  

Effect of Retroperitoneal Laparoscopic Nephrectomy on Non-functional Hydronephrosis and Its Influence on Stress Response

作　　者：梁元 杨晓荣 刘裔道 黑炜翔 杨永刚 濮思远 杨枝云 姜加富 LIANG Yuan;YANG Xiaorong;LIU Yidao;HEI Weixiang;YANG Yonggang;PU Siyuan;YANG Zhiyun;JIANG Jiafu(Dehong Prefecture People’s Hospital,Mangshi 678400,China;不详)

机构地区：[1]德宏州人民医院,云南芒市678400

出　　处：《中外医学研究》2022年第32期10-13,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨后腹腔镜肾切除术治疗无功能肾积水的效果及对患者应激反应的影响。方法:选择2019年12月-2021年11月德宏州人民医院收治的98例无功能肾积水患者,采用随机数字表法将其分为参照组(n=49)和研究组(n=49)。参照组采用开放式肾切除术治疗,研究组采用后腹腔镜肾切除术,两组均随访1个月。比较两组患者的临床疗效,围手术期指标,术前和术后1 d的应激反应指标,术后1、3、7 d的疼痛评分及并发症发生率。结果:研究组总有效率为95.92%,高于参照组的81.63%(P<0.05)。研究组手术时间、下床活动时间、术后排气时间、住院时间均短于参照组,术中出血量低于参照组(P<0.05)。术后1 d,两组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于术前,研究组高于参照组(P<0.05);术后1 d,两组血清CD8^(+)水平高于术前,研究组低于参照组(P<0.05)。术后7 d,两组VAS评分低于术后1、3 d,术后3 d低于术后1 d(P<0.05),术后1、3、7 d,研究组VAS评分低于参照组(P<0.05)。住院期间,研究组的并发症总发生率为6.12%,虽低于参照组的18.37%,但差异无统计学意义(P>0.05)。结论:后腹腔镜肾切除术可改善无功能肾积水患者围手术期指标,减轻机体应激反应,有利于患者术后恢复,疗效显著。Objective:To investigate the effect of retroperitoneal laparoscopic nephrectomy on non-functional hydronephrosis and its influence on stress response.Method:A total of 98 patients with non-functional hydronephrosis admitted to Dehong Prefecture People’s Hospital from December 2019 to November 2021 were selected and divided into the reference group(n=49)and the study group(n=49)by random number table method.The reference group was treated with open nephrectomy,while the study group was treated with retroperitoneal laparoscopic nephrectomy.Both groups were followed up for 1 month.The clinical efficacy of the two groups of patients was compared,the perioperative indexes,stress response indexes before operation and 1 day after operation,pain scores at 1,3 and 7 days after operation and the incidence of complications were compared between the two groups.Result:The total effective rate of the study group was 95.92%,which was higher than 81.63%of the reference group(P<0.05).The operation time,ambulation time,postoperative exhaust time and hospital stay in the study group were shorter than those in the reference group,and the intraoperative blood loss was lower than that in the reference group(P<0.05).At 1 day after operation,the serum levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before operation,and the study group were higher than those in the reference group(P<0.05).At 1 day after operation,the serum CD8^(+)level of the two groups were higher than those before operation,and the study group was lower than that of the reference group(P<0.05).At 7 days after operation,the VAS scores of the two groups were lower than those at 1 day and 3 days after operation,and the VAS scores at 3 days after operation were lower than those at 1 day after operation(P<0.05).At 1,3,and 7 days after operation,the VAS scores of the study group were lower than those of the reference group(P<0.05).During hospitalization,the total incidence of complications in the study group was 6.12%,which was lower tha

关 键 词：无功能肾积水 后腹腔镜肾切除术 疗效 应激反应 

分 类 号：R699.2[医药卫生—泌尿科学]