完全不阻断肾动脉腹腔镜肾部分切除术治疗肾恶性肿瘤的效果(1)
[摘要] 目的 探讨完全不阻断肾动脉腹腔镜肾部分切除术治疗肾恶性肿瘤的效果。 方法 选取河北医科大学附属沧州中心医院2013年10月～2015年10月诊治的肾恶性肿瘤患者70例，根据治疗方案分为两组，对照组患者37例实施选择性阻断肾动脉腹腔镜肾部分切除术治疗，观察组患者33例实施完全不阻断肾动脉腹腔镜肾部分切除术治疗，比较两组的临床效果。 结果 观察组手术时间、术后住院时间短于对照组，术中出血量多于对照组，输血率高于对照组，差异有统计学意义(P < 0.05)。两组术后血肌酐、尿素氮较术前显著升高(P < 0.05)，术后肾小球滤过率较术前显著降低(P < 0.05)；观察组术后血肌酐、尿素氮低于对照组(P < 0.05)，术后肾小球滤过率高于对照组(P < 0.05)。观察组并发症发生率低于对照组(P < 0.05)。 结论 完全不阻断肾动脉腹腔镜肾部分切除术治疗肾恶性肿瘤的效果显著，有助于保护肾功能，且安全性高，值得临床推广应用。
[关键词] 肾动脉；腹腔镜；恶性肿瘤；治疗效果；安全性
[中图分类号] R737 [文献标识码] A [文章编号] 1673-7210(2017)04(b)-0079-04
[Abstract] Objective To investigate effect of laparoscopic partial nephrectomy without interruption of renal artery in the treatment of renal malignant tumor. Methods 70 patients with renal malignant tumor were selected in Cangzhou Central Hospital Affiliated to Hebei Medical University from October 2013 to October 2015 were selected and divided into two groups by treatment program. 37 patients were received selective occlusion of renal artery for laparoscopic partial nephrectomy as control group. 33 patients were received laparoscopic partial nephrectomy without interruption of renal artery as observation group. Clinical effect was compared between two groups. Results The operation time and postoperative hospital stay in observation group were shorter than those in control group， intraoperative blood loss in observation group was more than that in control group， transfusion rate in observation group was higher than that in control group， with statistical differences (P < 0.05). Serum creatinine and urea nitrogen in two groups after operation were significantly higher than before operation (P < 0.05)， glomerular filtration rate in two groups was after operation significantly lower than before operation (P < 0.05). The serum creatinine and urea nitrogen in observation group after operation were lower than those in control group (P < 0.05)， glomerular filtration rate in observation group after operation was higher than that in control group (P < 0.05). The incidence rate of complication in observation group was lower than that in control group (P < 0.05). Conclusion Clinical effect of laparoscopic partial nephrectomy without interruption of renal artery in the treatment of renal malignant tumor is significant， which is helpful to protect renal function and has high safety. It is worthy of clinical promotion and application.
[Key words] Renal artery； Laparoscopy； Malignant tumor； Therapeutic effect； Safety']
腎癌是泌尿系统常见的一种恶性肿瘤疾病[1]，由于平均寿命延长和医学影像学技术的进步，肾癌的发病率和检出率均显著增加，由于该病临床上并无明显症状，而多在体检时偶然发现，其发病率可高达50%～70%[2-4]。手术治疗是肾癌患者的常用方法[5]，但肾部分切除术中热缺血会损伤肾功能，热缺血时间越长，患者的术后越差，肾功能衰竭的风险越高[6-7]。如何提高手术疗效的同时，降低手术并发症风险[8]，成为临床讨论的热点话题。此次研究对37例肾恶性肿瘤患者实施选择性阻断肾动脉腹腔镜肾部分切除术治疗，33例肾恶性肿瘤患者实施完全不阻断肾动脉腹腔镜肾部分切除术治疗，针对两组患者的临床治疗效果进行对比。, 百拇医药(姜利宁 季德才 鄂文娜 郝斌 李宏志 董永良 李英杰)
[关键词] 肾动脉；腹腔镜；恶性肿瘤；治疗效果；安全性
[中图分类号] R737 [文献标识码] A [文章编号] 1673-7210(2017)04(b)-0079-04
[Abstract] Objective To investigate effect of laparoscopic partial nephrectomy without interruption of renal artery in the treatment of renal malignant tumor. Methods 70 patients with renal malignant tumor were selected in Cangzhou Central Hospital Affiliated to Hebei Medical University from October 2013 to October 2015 were selected and divided into two groups by treatment program. 37 patients were received selective occlusion of renal artery for laparoscopic partial nephrectomy as control group. 33 patients were received laparoscopic partial nephrectomy without interruption of renal artery as observation group. Clinical effect was compared between two groups. Results The operation time and postoperative hospital stay in observation group were shorter than those in control group， intraoperative blood loss in observation group was more than that in control group， transfusion rate in observation group was higher than that in control group， with statistical differences (P < 0.05). Serum creatinine and urea nitrogen in two groups after operation were significantly higher than before operation (P < 0.05)， glomerular filtration rate in two groups was after operation significantly lower than before operation (P < 0.05). The serum creatinine and urea nitrogen in observation group after operation were lower than those in control group (P < 0.05)， glomerular filtration rate in observation group after operation was higher than that in control group (P < 0.05). The incidence rate of complication in observation group was lower than that in control group (P < 0.05). Conclusion Clinical effect of laparoscopic partial nephrectomy without interruption of renal artery in the treatment of renal malignant tumor is significant， which is helpful to protect renal function and has high safety. It is worthy of clinical promotion and application.
[Key words] Renal artery； Laparoscopy； Malignant tumor； Therapeutic effect； Safety']
腎癌是泌尿系统常见的一种恶性肿瘤疾病[1]，由于平均寿命延长和医学影像学技术的进步，肾癌的发病率和检出率均显著增加，由于该病临床上并无明显症状，而多在体检时偶然发现，其发病率可高达50%～70%[2-4]。手术治疗是肾癌患者的常用方法[5]，但肾部分切除术中热缺血会损伤肾功能，热缺血时间越长，患者的术后越差，肾功能衰竭的风险越高[6-7]。如何提高手术疗效的同时，降低手术并发症风险[8]，成为临床讨论的热点话题。此次研究对37例肾恶性肿瘤患者实施选择性阻断肾动脉腹腔镜肾部分切除术治疗，33例肾恶性肿瘤患者实施完全不阻断肾动脉腹腔镜肾部分切除术治疗，针对两组患者的临床治疗效果进行对比。, 百拇医药(姜利宁 季德才 鄂文娜 郝斌 李宏志 董永良 李英杰)