腹腔镜与开放手术治疗肾上腺嗜铬细胞瘤安全性的比较
腹腔镜,,肾上腺嗜铬细胞瘤；腹腔镜外科手术；安全,1资料与方法,2结果,3讨论,参考文献：
【摘要】 目的：比较肾上腺嗜铬细胞瘤腹腔镜术与开放手术的安全性，探讨保证和提高腹腔镜术安全性的方法。方法：使用腹腔镜技术治疗肾上腺嗜铬细胞瘤26例，以同期26例开放手术作为对照。选取术中血压、心率、血浆去甲肾上腺素(NE)浓度以及手术时间、术中出血量、术中输血例数、术后下床活动时间、术后住院时间等指标作比较。去甲肾上腺素的测定用反向高效液相色谱串联电化学检测内标法(RPHPLCECD)。结果：两组手术均获成功，随诊未见复发。术中血压、心率剧烈波动例数：腹腔镜手术组5例(5/26，19.2%)，血压最高220/110mm Hg，最低88/57mm Hg，心率最高122次/min；开放手术组16例(16/26，61.5%)，血压最高210mm Hg/115mm Hg，最低85mm Hg/60mm Hg，心率最高120次/min。每次波动都伴有去甲肾上腺素明显升高(P<0.01)，其中最高16.82ng/ml，最低6.28ng/ml(正常值为0.32ng/ml)。其它指标：腹腔镜手术组/开放手术组的手术时间68±12min/131±33min(t=5.275，P<0.001)；出血量38±11ml/218±73ml(t=8.692，P<0.001)；术中输血1例/17例；术后下床活动时间2.7±0.5d/5.2±0.5d(t=10.622，P<0.001)；术后住院时间5.7±1.2d/8.8±2.1d(t=6.201，P<0.001)均有明显差异。结论：有丰富腹腔镜肾上腺瘤的手术经验，在肿瘤体积、手术空间的创建、判断肿瘤的位置、肾上腺血管的处理、暴露和游离肿瘤等几方面遵循一定的原则，选择直径小于3.5cm的肾上腺嗜铬细胞瘤开展腹腔镜手术的安全性不低于开放手术。【关键词】肾上腺嗜铬细胞瘤；腹腔镜外科手术；安全
Safety compare between open and laparoscopic surgery of adrenal pheochromocytoma
QIU Shaopeng,CHEN Yu，CHEN Wei,et al.
Department of Urology,The First Affiliated Hospital,Sun Yatsen University,Guangzhou510080,China
【Abstract】Objective:To compare the safety between open and laparoscopic surgery of adrenal pheochromocytoma.Methods：Laparoscopic excision of pheochromocytoma was performed on 26 patients with pheochromocytoma,at same term 26 patients with pheochromocytoma were underwent open surgery. The postoperative outcomes including intraoperative blood pressure,heart rate,noradrenalin(NE)concentration in plasma,operative time,volume of blood loss,cases received blood transfusion,postoperative in bed days,postoperative hospital stay were compared between the 2 groups. The mensuration of noradrenalin(NE)adopt(RPHPLCECD).Results:All patients were successful in 2 groups,no patients recrudescence.Intraoperative 5 cases(5/26,19.2%)in laparoscopic surgery group vs 16 cases(16/26,61.5%)in open surgery group had blood pressure,heart rate and pulse acute change(corresponding blood pressure max 220/110mm Hg vs 210/115mm Hg, blood pressure min 88/57mm Hg vs 85/60mm Hg,heart rate max 122bpm vs 120bpm).Others outcomes in two groups respsctive operative time 68±12min/131±33min(t=5.275 ......
您现在查看是摘要页，全文长 9810 字符。