摘要
目的评估影像学MAP评分对T1期肾肿瘤切除术式选择的指导意义。方法回顾性分析214例T1期肾肿瘤患者的临床资料,其中开腹肾部分切除术(OPN)62例,腹腔镜肾部分切除术(LPN)57例,开腹肾根治切除术(ORN)38例,腹腔镜肾根治切除术(LRN)57例。所有病例按照MAP评分标准分为MAP低分组(0~1分)、MAP中分组(2~3分)和MAP高分组(4~5分)。分析相同MAP组不同术式组间患者手术时间、术中出血量、术后住院时间、术后并发症等手术相关指标的差异,以及同一术式不同MAP组间各相应指标的差异。结果MAP评分与性别、高血压/糖尿病、术后并发症明显相关(P<0.05)。MAP低、中、高分组进行组间比较:开腹手术患者各组间手术相关指标差异均不存在统计学意义(P>0.05);腔镜手术患者,各组间住院时间差异不存在统计学意义,其余各项手术相关指标差异均有统计学意义(P>0.05)。MAP低、中、高分组进行组内比较:在MAP低分组及中分组中,腹腔镜手术比开腹手术手术时间稍长、术中出血少(P<0.05),术后并发症无差异性;在MAP高分组中,LPN较OPN手术时间、术中出血、术后并发症增多(P<0.05),LRN较ORN手术时间、术后并发症增多(P<0.05),术中出血无明显差异性;住院时间在不同术式组间差异均不存统计学意义(P>0.05)。结论MAP评分适用于腹腔镜肾根治性切除术及腹腔镜肾部分切除术术前相关情况的评估,而不适用于开放手术。MAP低分组及中分组适宜行腹腔镜手术,而MAP高分组适宜行开腹手术。
Objective To evaluate the significance of imaging-based MAP score in guiding the selection of T1 renal tumor resection.Methods The clinical data of 214 patients with T1 renal tumor,who were admitted in our hospital from January 2014 to December 2008 were retrospectively analyzed,including 62 cases of open partial nephrectomy(OPN),57 cases of laparoscopic partial nephrectomy(LPN),38 cases of open radical nephrectomy(ORN)and 57 cases of laparoscopic radical nephrectomy(LRN).All patients were divided into low-MAP group(0-1 points),moderate-MAP group(2-3 points)and high-MAP group(4-5 points)according to MAP scoring criteria.We analyzed the differences in surgical-related factors such as operation time,intraoperative blood loss,postoperative hospitalization time,postoperative complications between different operation methods in the same MAP group,and those between different MAP groups in the same operation method.Results MAP score was significantly correlated with gender,hypertension/diabetes,and postoperative complications(P<0.05).Comparison among groups of MAP low,medium and high:In the open surgery group,there were no statistically differences in operation related indexes(P>0.05).In the laparoscopic surgery group,except for the postoperative hospitalization time,there were statistically differences in other operation related indexes.Intra-group comparison of MAP low,medium and high groups:between the low-MAP group and moderate-MAP group,patients undergoing laparoscopic surgery had a slightly longer operation time and less intraoperative blood loss(P<0.05),and there was no difference in postoperative complications.In the high-MAP group,patients undergoing LPN had more operation time,intraoperative blood loss and postoperative complications than patients undergoing OPN(P<0.05).Patients undergoing LRN had more operation time and postoperative complications than patients receiving ORN(P<0.05),but there was no significant difference in intraoperative blood loss.There was no statistical difference in postoperative hospitalization time in different surgical groups(P<0.05).Conclusion MAP score is suitable for the evaluation of relevant conditions before laparoscopic partial nephrectomy and laparoscopic radical nephrectomy,but it is not suitable for open surgery.MAP low-group and middle-group are suitable for laparoscopic surgery,while MAP high-group is suitable for open surgery.
作者
常瑞亭
孙瑞雪
于天舒
姜立杰
王东昕
CHANG Ruiting;SUN Ruixue;YU Tianshu(Department of Radiology,The People's Hospital of Hengshui,Hengshui,Hebei Province 053000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第10期2028-2032,共5页
Journal of Clinical Radiology
基金
衡水市科技计划自筹经费项目(编号:20180140212)
