经后腹腔与经腹入路腹腔镜肾部分切除术对早期肾癌患者免疫功能及术后并发症的影响  

The Effect of Laparoscopic Partial Nephrectomy Through Retroperitone⁃aland Transabdominal Approacheson Immune Functionand Postoperative Complicationsin Early Renal Cell Carcinoma Patients

作　　者：邹庆波 ZOU Qingbo(Department of Urology,Jinan Integrated Traditional Chineseand Western Medicine Hospital,Jinan,Shandong,271100,China)

机构地区：[1]济南市中西医结合医院泌尿外科,山东济南271100

出　　处：《中外医疗》2025年第4期6-9,共4页China & Foreign Medical Treatment

摘　　要：目的比较腹腔镜肾部分切除术中经后腹腔、经腹两种入路方式治疗对早期肾癌患者的影响,分析免疫功能、并发症等指标。方法方便选取2022年1月—2023年1月济南市中西医结合医院收治的74例拟行腹腔镜肾部分切除术患者为研究对象,根据不同手术方式分为观察组(37例)、对照组(37例)。观察组运用经后腹腔入路,对照组运用经腹入路,比较两组手术情况、应激反应、免疫功能及术后并发症。结果两组术中出血量、热缺血时间对比,差异均无统计学意义(P均>0.05)。观察组手术时间(107.86±15.41)min、住院时间(7.86±1.42)d均短于对照组的(122.34±15.79)min、(9.87±1.32)d,差异均有统计学意义(t=3.992,6.306;P均<0.05)。相较于术前,两组应激反应指标术后更高,免疫功能术后更低;观察组皮质醇、C反应蛋白、白细胞计数水平均低于对照组,免疫功能高于对照组,差异均有统计学意义(P均<0.05)。两组并发症总发生率对比,差异无统计学意义(P>0.05)。结论相较于经腹入路,早期肾癌患者腹腔镜肾部分切除术中应用经后腹腔入路的方式能缩短手术和住院时间,降低应激反应,减轻对免疫功能的影响,同时两者术后并发症均较少。Objective To compare the effects of retroperitoneal and transabdominal approaches in laparoscopic partial nephrectomy on patients with early renal cell carcinoma,and to analyze the indexes of immune function and complica⁃tions.Methods From January 2022 to January 2023,74 patients undergoing laparoscopic partial nephrectomy in Jinan Integrated Traditional Chinese and Western Medicine Hospital were conveniently selected as the research objects and divided into observation group(37 cases)and control group(37 cases)according to different surgical methods.The ob⁃servation group was treated with retroperitoneal approach,and the control group was treated with transabdominal ap⁃proach.The operation,stress response,immune function and postoperative complications were compared between the two groups.Results There was no significant difference in intraoperative blood loss and warm ischemia time between the two groups(both P>0.05).The operation time(107.86±15.41)min and hospitalization time(7.86±1.42)d in the ob⁃servation group were shorter than those in the control group(122.34±15.79)min and(9.87±1.32)d,and the differ⁃ences were statistically significant(t=3.992,6.306;both P<0.05).Compared with before operation,the stress response indexes of the two groups were higher after operation,and the immune function was lower after operation.The levels of cortisol,C-reactive protein and white blood cell count in the observation group were lower than those in the control group, and the immune function was higher than that in the control group. the differences were statistically significant(all P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). Conclusion Compared with transperitoneal approach, the application of retroperitoneal approach in laparoscopicpartial nephrectomy for patients with early renal cell carcinoma can shorten the operation and hospitalization time, re⁃duce the stress response, and reduce the impact on immune function. At the same time

关 键 词：早期肾癌 腹腔镜 经后腹腔入路 经腹入路 免疫功能 

分 类 号：R6[医药卫生—外科学]