摘要
目的探讨后腹腔镜肾部分切除术(RLPN)与开放性肾部分切除术(OPN)治疗复杂性肾肿瘤的临床效果。方法我院152例复杂性肾肿瘤患者,行RLPN者纳入观察组(n=95),行OPN者纳入对照组(n=57)。比较术后2周、3个月时,两组肾功能指标、血清炎症因子变化,围术期基本情况及术后2周内并发症发生率。结果术后2周时,两组血肌酐(SCr)、胱抑素C(Cys-C)水平均较治疗前提升,且观察组高于对照组;两组肾小球滤过率(e GFR)水平较治疗前下降,且观察组低于对照组;两组肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均较术前提升,且观察组低于对照组(P <0. 05)。术后3个月时,两组SCr、Cys-C、TNF-α、CRP、IL-6水平均较治疗前提升,e GFR水平较治疗前下降(P <0. 05),组间比较差异均无统计学意义(P> 0. 05)。观察组阻断时间、手术时间均高于对照组,术中失血量、术后引流时间、术后肛门排气时间、术后住院时间均少于对照组(P <0. 05)。术后2周内,观察组并发症发生率低于对照组(P <0. 05)。结论 RLPN与OPN治疗复杂性肾肿瘤近期疗效均属良好,但前者安全性更为理想,有利于促进患者预后康复。
Objective To investigate the clinical effects of retroperitoneal laparoscopic partial nephrectomy( RLPN) and open partial nephrectomy( OPN) for complex renal tumors. Methods The clinical data of 152 patients with complex renal tumors in our hospital were retrospectively analyzed.Patients with RLPN were included in observation group( n = 95),and patients with OPN were included in control group( n = 57). The changes of renal function indexes and serum inflammatory factors before operation and at 2weeks and 3 months after operation,and the basic perioperative conditions and the concurrence of complications within 2 weeks after operation were compared between the two groups.Results At 2 weeks after operation,the levels of serum creatinine( SCr) and cystatin C( Cys-C) in the two groups were significantly higher than those before operation,and the levels in observation group were significantly higher than those in control group( all P < 0. 05). The estimated glomerular filtration rate( e GFR) level after operation in the two groups was significantly lower than that before operation,and the level in the observation group was significantly lower than that in the control group( all P < 0. 05).The levels of tumor necrosis factor-α( TNF-α),C-reactive protein( CRP) and interleukin-6( IL-6) after operation in the two groups were significantly higher than those before operation,and the levels in observation group were significantly lower than those in the control group at the same time( all P < 0. 05).After 3 months of operation,the levels of SCr,Cys-C,TNF-α,CRP and IL-6 in the two groups were significantly higher than those before operation while the e GFR level was significantly lower than that before operation( all P < 0. 05).However,there was no statistical difference between the groups( all P > 0. 05).The blocking time and operative time in the observation group were significantly longer than those in the control group,but intraoperative blood loss,postoperative drainage time,postoperative anus exhaust time and postoperative hospital stay were significantly less than those in the control group( all P < 0. 05).Within 2 weeks after operation,the incidence rate of complications in the observation group was significantly lower than that in the control group( P < 0. 05).Conclusion Both RLPN and OPN have good short-term efficacy in treatment of complex renal tumors,but the former has more ideal safety and is conducive to the prognosis of the patients.
作者
胡跃世
李明林
曹志华
陶林静
李鹏
王阳
刘磊
HU Yue-shi;LI Ming-lin;CAO Zhi-hua;TAO Lin-jing;LI Peng;WANG Yang;LIU Lei(Department of Urology, Nanyang Central Hospital, Nanyang 473000, Henan, China)
出处
《实用医院临床杂志》
2019年第1期154-157,共4页
Practical Journal of Clinical Medicine
