腹腔镜下保留肾单位手术与后腹腔镜肾癌根治术对非晚期肾癌患者免疫功能的影响  

Effect of laparoscopic surgery with preserved renal units and posterior laparoscopic radical nephrectomy on immune function in patients with non-advanced renal cancer

作　　者：焦春军 崔文信 郭硕磊 Jiao Chunjun;Cui Wenxin;Guo Shuolei(Department of Urology,Shangqiu the Third People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]河南商丘市第三人民医院泌尿外科,商丘476000

出　　处：《河南外科学杂志》2024年第5期22-25,共4页Henan Journal of Surgery

摘　　要：目的对比腹腔镜下保留肾单位手术(LNSS)与后腹腔镜肾癌根治术(RLRN)治疗非晚期肾癌患者的效果及对免疫功能的影响。方法回顾性收集商丘市第三人民医院2020-04—2023-04收治的150例非晚期肾癌患者的病例资料,按手术方案不同分为2组。行LNSS治疗的75例患者列为A组,行RLRN治疗的75例患者列为B组。对比2组手术指标,手术前后血尿素氮(BUN)、血肌酐(Scr)、明胶酶相关脂质运载蛋白(NGAL)肾功能,欧洲癌症研究与治疗组织生命质量测定量表(EORTC QOL-C30)评分,免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平,并发症发生率。结果A组术中失血量少于B组,术后第3天时的BUN、Scr、NGAL水平低于B组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于B组,术后禁食时间及住院时间短于B组,差异均有统计学意义(P<0.05);A组术后3个月时的EORTC QOL-C30评分高于B组,并发症发生率低于B组,差异有统计学意义(P<0.05)。结论与RLRN治疗非晚期肾癌患者比较,经LNSS治疗有助于减少术中出血量,降低并发症发生风险,缩短患者康复进程,提升生活质量,且对机体肾功能、免疫功能造成的影响较小。Objective To compare the effect of laparoscopic renal unit-sparing surgery(LNSS)with posterior laparoscopic radical nephrectomy(RLRN)in the treatment of patients with non-advanced renal cancer and the effect on immune function.Methods The data of 150 patients with non-advanced renal carcinoma(from April 2020 to April 2023)in Shangqiu the Third People's Hospital were retrospectively collected and divided into 2 groups according to different surgical protocols.75 patients treated with LNSS were classified as group A and 75 patients treated with RLRN were classified as group B.Preoperative and postoperative renal function[blood urea nitrogen(BUN),creatinine(Scr),gelatinase-associated lipid carrier protein(NGAL)]and the European Cancer Research and Treatment Tissue Quality of Life Scale(EORTC)were compared between the two groups (QOL-C30)score,Immune function(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))levels,complication rates.Results The intraoperative blood loss in group A was less than that in group B,BUN,Scr,and NGAL levels at 3d were lower than that of group B,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels were higher than group B,and the postoperative fasting time and hospitalization time were shorter than those in group B,and the differences were statistically significant(P<0.05).The EORTC QOL-C30 score was higher than that of Group B and the complication rate was lower than that of Group B(P<0.05).Conclusion Compared with RLRN in the treatment of non-advanced renal cancer patients,LNSS treatment is more helpful to reduce intraoperative blood loss,reduce the risk of complications,shorten the rehabilitation process of patients,improve the quality of life,and have less impact on the body's renal function and immune function.

关 键 词：腹腔镜下保留肾单位手术 肾癌 后腹腔镜肾癌根治术 免疫功能 

分 类 号：R737.11[医药卫生—肿瘤]