MAP评分对经腹腹腔镜根治性肾切除术手术难度的预测价值  

Clinical analysis of MAP in transabdominal laparoscopic radical nephrectomy of renal cell carcinoma

作　　者：张锟 李雪琴[2] 刘娟[3] 仲冰[1] 王功成[1] ZHANG Kun;LI Xueqin;LIU Juan;ZHONG Bing;WANG Gongcheng(Department of Urology,The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300;Department of General Practice,The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300;Department of Geriatric Endocrinology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属淮安第一医院泌尿外科,江苏淮安223300 [2]南京医科大学附属淮安第一医院全科医学科,江苏淮安223300 [3]南京医科大学第一附属医院老年医学科,江苏南京210000

出　　处：《现代泌尿外科杂志》2023年第8期649-653,共5页Journal of Modern Urology

基　　金：国家自然科学基金资助项目(No.81570773);江苏省博士后科研资助计划(No.2017-1701060B)。

摘　　要：目的 分析肾周脂肪梅奥黏连概率评分(MAP)对行经腹腹腔镜根治性肾切除术(LRN)的肾细胞癌(RCC)患者的手术难度以及术后恢复情况的预测价值。方法 回顾性分析南京医科大学附属淮安第一医院泌尿外科2017年1月-2020年12月行经腹LRN治疗的168例RCC患者的病历资料,根据MAP评分将患者分为MAP低分(≤3分)组100例和MAP高分(>3分)组68例,比较两组患者围手术期相关临床资料的差异。结果 与MAP低分组患者比较,MAP高分组患者手术时间较长(P<0.001),术中出血量较多(P<0.001),并发症Clavien-Dindo分级较高(P=0.008),术后住院时间较长(P=0.003),术后C反应蛋白(P=0.030)及白介素-6含量较高(P=0.009),术后血白蛋白(P<0.001)和前白蛋白含量较低(P=0.020),差异均具有统计学意义。结论 肾周脂肪MAP评分能提前评估经腹LRN术中患者手术时间延长、出血量增加的风险,还可以预测患者术后恢复情况,从而指导泌尿外科医师做好术前规划。Objective To evaluate the significance of Mayo adhesive probability(MAP)in predicting surgical difficulty and postoperative recovery in patients with renal cell carcinoma(RCC)undergoing laparoscopic radical nephrectomy(LRN).Methods The clinical data of 168 RCC patients who received transabdominal LRN during Jan.2017 and Dec.2020 were retrospectively analyzed.According to MAP,the patients were divided into low MAP group(n=100)and high MAP group(n=68).The differences in perioperative clinical data were compared between the two groups.Results Compared with low MAP group,the high MAP group had longer operation time(P<0.001),more intraoperative blood loss(P<0.001),higher Clavien-Dindo grade complications(P=0.008),longer hospital stay(P=0.003),higher levels of c-reactive protein(P=0.030)and IL-6(P=0.009),lower levels of albumin(P<0.001)and prealbumin(P=0.020).Conclusion MAP can assess the risk of prolonged operation time,increased bleeding during transabdominal LRN,and postoperative recovery,thus guiding the preoperative planning.

关 键 词：肾周脂肪梅奥黏连概率评分 腹腔镜 根治性肾切除术 肾癌 

分 类 号：R737.11[医药卫生—肿瘤]