不同入路腹腔镜肾部分切除术在早期肾癌患者中的应用  

Laparoscopic partial nephrectomy with different approaches in patients with early renal cancer

作　　者：黄涛涛 贾红星[1] 酒全帅 牛志宏[1] 王坦 Huang Taotao;Jia Hongxing;Jiu Quanshuai;Niu Zhihong;Wang Tan(Department of Urology,Jiaozuo People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院泌尿外科,454000

出　　处：《国际移植与血液净化杂志》2023年第5期22-25,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探索不同入路腹腔镜肾部分切除术在早期肾癌患者中的应用及其对应激指标和免疫功能等的影响。方法选取焦作市人民医院泌尿外科2020年8月至2022年12月收治的88例早期肾癌患者作为研究对象,依照手术入路方式分为常规经腹入路组和经后腹腔入路组。常规经腹入路组44例,采用经腹入路腹腔镜肾部分切除术。经后腹腔入路组44例,采用经后腹腔入路腹腔镜肾部分切除术,对比两组患者手术指标、应激指标、免疫功能、并发症发生情况。结果经后腹腔入路组手术通道建立时间、手术时间、术中出血量、术后出血量低于常规经腹入路组(P<0.05)。两组术后12 h血清肾上腺素、丙二醛、晚期氧化蛋白产物水平均较术前升高,经后腹腔入路组低于常规经腹入路组(P<0.05)。两组术后12 h CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)淋巴细胞水平均较术前降低,经后腹腔入路组高于常规经腹入路组(P<0.05)。经后腹腔入路组并发症发生率(4.55%)与常规经腹入路组(11.36%)对比差异无统计学意义(P>0.05)。结论经后腹腔入路腹腔镜肾部分切除术可调节早期肾癌患者免疫功能,改善手术指标,调控应激指标,安全性良好。Objective To explore the application of laparoscopic partial nephrectomy with different approaches in patients with early renal cancer and its influence on stress indexes and immune function.Methods A total of 88 patients with early renal cancer in our hospital from August 2020 to December 2022 were selected as research subjects.According to the surgical approach,the patients were divided into conventional transabdominal approach group and retroabdominal approach group.Forty-four patients in the conventional transabdominal approach group received transabdominal laparoscopic partial nephrectomy,and 44 patients in the retroabdominal approach group received transabdominal laparoscopic partial nephrectomy.The surgical indexes,stress indexes,immune function,and complications of the two groups were compared.Results The operation channel establishment time,operation time,intraoperative blood loss and postoperative blood loss in the retroperitoneal approach group were lower than those in the conventional peritoneal approach group(P<0.05).The serum levels of epinephrine,malondialdehyde and late oxidized protein product at 12 h after surgery were higher than those before surgery,and those in the retroperitoneal approach group were lower than those in the conventional peritoneal approach group(P<0.05).The levels of CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)lymphocytes 12 h after surgery in both groups were lower than those before surgery,and those in the retroperitoneal approach group were higher than those in the conventional peritoneal approach group(P<0.05).There was no significant difference in the complication rate between the retroperitoneal approach group(4.55%)and the conventional peritoneal approach group(11.36%)(P>0.05).Conclusion Retroperitoneal approach laparoscopic partial nephrectomy can regulate immune function,improve surgical indexes,regulate stress indexes,and has good safety.

关 键 词：腹腔镜肾部分切除术 肾癌 应激指标 免疫功能 

分 类 号：R737.11[医药卫生—肿瘤]