探讨优先精准解剖肾上腺中央静脉在后腹腔镜肾上腺肿瘤切除术中的应用价值  

Exploration on the Application Value of Prior Accurate Anatomy of the Central Adrenal Vein in Retroperitoneal Laparoscopic Adrenal Tumor Resection

作　　者：蔡兰辉 CAI Lanhui(Department of Urology,Putian First Hospital,Putian,Fujian Province,351100 China)

机构地区：[1]莆田市第一医院泌尿外科,福建莆田351100

出　　处：《中外医疗》2023年第5期38-41,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨优先精准解剖肾上腺中央静脉在后腹腔镜肾上腺肿瘤切除术中的应用价值分析。方法 回顾性分析2017年1月—2021年3月莆田市第一医院收治的以肾上腺肿瘤为诊断并拟接受后腹腔镜肾上腺肿瘤切除术患者42例的临床资料,根据手术方式分为研究组和对照组,以术中优先精准解剖肾上腺中央静脉手术方案治疗的20例患者为研究组,采取常规手术方案的22例患者为对照组。比较两组患者术中指标、术后康复指标。结果 两组患者术中均没有输血病例。与对照组相比,研究组患者手术时间更短、术中出血量更少,研究组患者术中血压波动率10.00%低于对照组的40.91%,差异有统计学意义(P<0.05);研究组术后镇痛药物使用率40.00%低于对照组50.00%,差异无统计学意义(P>0.05)。而研究组患者术后首次进食、首次下床、引流管拔除及出院时间更短,术后第1天8点血浆皮质醇水平更高,差异有统计学意义(P<0.05)。结论 在后腹腔镜肾上腺肿瘤切除术中,开展优先精准解剖肾上腺中央静脉手术方案可以缩短手术时间,减少术中出血量,降低术中血压波动率,对术后患者肾上腺激素水平影响更小,加快患者术后进食、下床及缩短引流管拔除、出院时间,效果理想。Objective To discuss the application value of priority and accurate dissection of the central adrenal vein in posterior laparoscopic adrenal tumor resection was analyzed.Methods A retrospective analysis was performed for 42 patients of clinical data admitted to the First Hospital of Putian from January 2017 to March 2021 who were diagnosed with adrenal tumors and were going to undergo laparoscopic adrenal tumor resection,and were divided into study group and control group according to the surgical method,with 20 patients treated by the surgical plan of intraoperative priority and accurate dissection of the central adrenal gland as the study group,and 22 patients with conventional surgery as the control group.The intraoperative indexes and postoperative rehabilitation indexes of the two groups were compared.Results There were no cases of blood transfusion in either group.Compared with the control group,the intraoperative blood pressure fluctuation of 10.00%in the study group was lower than that of the control group by 40.91%,and the use rate of postoperative analgesic drugs in the study group was 40.00%lower than that in the control group,and the difference was statistically significant(P<0.05),and the postoperative analgesic drug utilization rate in the study group was 40.00%lower than that in the control group by 50.00%,and the difference was not statistically significant(P>0.05).The first time to eat,get out of bed for the first time,drainage tube removal and discharge time were shorter in the study group,and the plasma cortisol level was higher at 8 o'clock on the first day after surgery,and the difference was statistically significant(P<0.05).Conclusion In posterior laparoscopic adrenal tumor resection,the priority and accurate dissection of central adrenal vein surgery can shorten the operation time,reduce intraoperative blood loss,reduce intraoperative blood pressure fluctuation,have less effect on the postoperative adrenal hormone level,accelerate the postoperative eating,get out of bed,shorten the drainag

关 键 词：优先精准解剖 肾上腺中央静脉 后腹腔镜 肾上腺肿瘤 切除术 手术时间 围术期指标 

分 类 号：R4[医药卫生—临床医学]