摘要
目的 探讨根治性肾切除与肾部分切除术后伤口引流液的肌酐水平以及手术前后血肌酐水平的变化情况，观察肾癌不同术式对肾功能的影响，并探讨伤口引流液肌酐的异常对判断术后尿瘘发生的意义。方法 收集2012年3月至2012年7月间手术的肾癌患者共65例，其中根治性肾切除34例，肾部分切除31例，所有患者均在术后24 h内测定血肌酐水平、伤口引流液肌酐水平，并在术后3个月复查血肌酐情况。分析行两种不同术式后血肌酐水平的变化及伤口引流液肌酐水平的差异。结果 根治性肾切除术组术后伤口引流液肌酐水平明显低于血肌酐[（99.94±21.10）μmol／L比（114.61±25.09）μmol／L，P＝0.000]。肾部分切除术后发生尿瘘1例（2.9 %），其术后血肌酐及引流液肌酐水平分别为107 μmol／L、686 μmol／L；其余30例肾部分切除术后伤口引流液肌酐水平也明显低于血肌酐水平[（92.90±26.21）μmol／L比（99.83±28.77）μmol／L，P＝0.021]。肾部分切除术后血肌酐水平明显低于根治性肾切除术（P＝0.035），但伤口引流液肌酐水平与根治性肾切除组无差异（P＝0.239）。 3个月后肾部分切除组血肌酐水平明显低于肾根治性切除组[（81.43±12.82）μmol／L比（106.53±21.73）μmol／L，P＝0.001]。结论 肾癌术后引流液肌酐水平明显低于血肌酐，引流液肌酐升高对判断肾部分切除术后尿瘘有帮助；肾癌患者肾部分切除术后肾功能恢复良好。
Objective To investigate the creatinine level of wound drainage and the changes of serum creatinine after radical nephrectomy or partial nephrectomy in patients with renal cell carcinoma, to explore the feasibility of testing creatinine level to predict urine leakage after surgery and to compare the influence on renal function after different kinds of operations. Methods 65 patients data were analyzed, in which 31 patients had undergone partial nephrectomy and 34 had radical nephrectomy for renal cell carcinoma from March 2012 to July 2012. The level of creatinine in serum and wound drainage were detected within 24 hours after surgery. Also, the serum creatinine were redetected 3 months later. Results The creatinine level of wound drainage were significantly lower than that in serum in both groups [（99.94±21.10） μmol/L vs （114.61±25.09） μmol/L, P = 0.000]. Urine leakage was observed in only one patient （2.9 %） after partial nephrectomy, which his level of creatinine in serum and wound drainage was 107 μmol/L and 686 μmol/L, respectively. The other 30 patients＇ creatinine level of wound drainage were also significantly lower than serum after partial nephrectomy [（92.90±26.21） μmol/L vs （99.83±28.77） μmol/L, P = 0.021）. Although the level of creatinine in the wound drainage was not significantly different between these two groups （P = 0.239）, the serum creatinine was statistical lower in partial nephrectomy group than that of radical nephrectomy group （P = 0.035）. Also, after three months, the partial nephrectomy group had a lower level of serum creatinine [（81.43±12.82） μmol/L vs （106.53±21.73） μmol/l, P = 0.001]. Conclusion Partial nephrectomy has advantages in protecting renal function when compared with radical nephrectomy. The level of creatinine in wound drainage is significantly lower than serum. The level of creatinine in wound drainage is a predictive indicator for diagnosing urine leakage.
出处
《肿瘤研究与临床》
CAS
2013年第8期527-529,534,共4页
Cancer Research and Clinic
关键词
肾肿瘤
肾功能
肌酸酐
尿瘘
Kidney neoplasms
Renal function
Creatinine
Urinary fistula
