目的:探讨基于CT三维重组技术的R.E.N.A.L.评分系统在腹腔镜肾部分切除术中的临床应用价值。方法:搜集我院2020年6月至2024年1月经手术治疗的79例肾肿瘤患者的临床及术前影像资料,根据术前肾脏CT三维重组结果,分析血管变异与肾脏热缺血...目的:探讨基于CT三维重组技术的R.E.N.A.L.评分系统在腹腔镜肾部分切除术中的临床应用价值。方法:搜集我院2020年6月至2024年1月经手术治疗的79例肾肿瘤患者的临床及术前影像资料,根据术前肾脏CT三维重组结果,分析血管变异与肾脏热缺血时间、手术总时间、术中出血量及术后并发症之间的关系,并进行R.E.N.A.L.评分。采用Logistic回归筛选出肾热缺血时间大于20 min的独立危险因素。结果:有无血管变异在肾脏热缺血时间、手术总时间、术中出血量及术后并发症之间无明显差异(P > 0.05)。R.E.N.A.L.总评分是肾热缺血时间大于20 min的独立危险因素(P P Objective: To explore the clinical application value of R.E.N.A.L. scoring system based on CT three-dimensional reconstruction technology in laparoscopic partial nephrectomy. Methods: The clinical and preoperative imaging data of 79 patients with renal tumors who underwent surgical treatment in our hospital from June 2020 to January 2024 were collected. According to the results of preoperative renal CT three-dimensional reconstruction, the relationship between vascular variation and renal warm ischemia time, total operation time, intraoperative bleeding and postoperative complications was analyzed, and R.E.N.A.L. score was performed. Logistic regression was used to screen out independent risk factors for renal warm ischemia time greater than 20 min. Results: There was no significant difference in renal warm ischemia time, total operation time, intraoperative blood loss and postoperative complications between the presence or absence of vascular variation (P > 0.05). The total R.E.N.A.L. score was an independent risk factor for renal warm ischemia time greater than 20 min (P P < 0.05). Conclusion: CT three-dimensional reconstruction can clearly understand the anatomical location of the kidney, tumor and blood vessels before surgery, thereby reducing the occurrence of perioperative complications.展开更多
患者,男性,54岁。头痛3月余,伴左侧肢体活动障碍半月余。患者3个月前无明显诱因出现头痛,半月前出现左侧肢体活动障碍,有进行性加重趋势,未出现抽搐、呕吐等情况。病程中,大小便正常,饮食睡眠一般,近期体质量未见明显减轻。体检:体温36....患者,男性,54岁。头痛3月余,伴左侧肢体活动障碍半月余。患者3个月前无明显诱因出现头痛,半月前出现左侧肢体活动障碍,有进行性加重趋势,未出现抽搐、呕吐等情况。病程中,大小便正常,饮食睡眠一般,近期体质量未见明显减轻。体检:体温36.5℃、脉搏99次/分、呼吸20次/分、血压128/80 mm Hg(1 mm Hg≈0.133 k Pa)。展开更多
文摘目的 探究双侧髂内动脉Fogarty球囊阻断术在剖宫产术后瘢痕妊娠(CSP)辅助清宫手术中的临床疗效与安全性。方法 回顾性分析阜阳市人民医院2021年1月至2022年9月收治的80例CSP患者临床资料。其中观察组40例,给予双侧髂内动脉Fogarty球囊阻断术下行宫腔镜下清宫治疗,术中间断阻断髂内动脉,清除胚胎、电凝或缝合止血;对照组40例,给予子宫动脉栓塞术(UAE)后1~2 d行宫腔镜下清宫手术。对比分析两组患者在数字减影血管造影(DSA)下透视时间、体表辐射剂量、清宫手术中出血量、清宫手术时间、住院时间及术后随访情况。结果 所有患者清宫手术顺利,成功保留子宫。观察组未发生球囊相关的并发症。对照组40例患者UAE后均发生不同程度发热、子宫区疼痛等栓塞后反应。观察组、对照组DSA下透视时间及体表辐射剂量分别为(9.2±1.1)s vs(1 273.6±141.1)s、(7.7±0.8)m Gy vs(1 503.8±101.8)mGy,分别比较,差异均有统计学意义(均P<0.05);清宫时术中出血量分别为(30.3±14.7) mL、(27.5±13.2) mL,清宫手术时间分别为(41.6±16.2) min、(42.8±15.0) min,分别比较,差异均无统计学意义(均P>0.05);住院时间分别为(6.0±0.7) d、(7.3±0.8) d,两组比较,差异有统计学意义(P<0.05)。随访期均在3个月以上,观察组、对照组人绒毛膜促性腺激素(β-hCG)转阴时间、阴道流血时间、月经恢复正常时间及患者满意率分别为(21.1±2.4) d vs (24.6±3.3) d、(8.2±1.1) d vs (13.6±2.6) d、(29.5±2.2) d vs(46.7±7.3) d、95.0%(38/40) vs 67.5%(27/40),分别比较,差异均有统计学意义(均P<0.05)。结论 双侧髂内动脉Fogarty球囊阻断术及UAE辅助CSP清宫手术均可明显减少术中出血量,但双侧髂内动脉Fogarty球囊阻断术相比于UAE,减少患者X线辐射剂量,缩短患者住院、β-hCG转阴、阴道流血、月经恢复正常时间,增加患者满意度率。
文摘目的:探讨基于CT三维重组技术的R.E.N.A.L.评分系统在腹腔镜肾部分切除术中的临床应用价值。方法:搜集我院2020年6月至2024年1月经手术治疗的79例肾肿瘤患者的临床及术前影像资料,根据术前肾脏CT三维重组结果,分析血管变异与肾脏热缺血时间、手术总时间、术中出血量及术后并发症之间的关系,并进行R.E.N.A.L.评分。采用Logistic回归筛选出肾热缺血时间大于20 min的独立危险因素。结果:有无血管变异在肾脏热缺血时间、手术总时间、术中出血量及术后并发症之间无明显差异(P > 0.05)。R.E.N.A.L.总评分是肾热缺血时间大于20 min的独立危险因素(P P Objective: To explore the clinical application value of R.E.N.A.L. scoring system based on CT three-dimensional reconstruction technology in laparoscopic partial nephrectomy. Methods: The clinical and preoperative imaging data of 79 patients with renal tumors who underwent surgical treatment in our hospital from June 2020 to January 2024 were collected. According to the results of preoperative renal CT three-dimensional reconstruction, the relationship between vascular variation and renal warm ischemia time, total operation time, intraoperative bleeding and postoperative complications was analyzed, and R.E.N.A.L. score was performed. Logistic regression was used to screen out independent risk factors for renal warm ischemia time greater than 20 min. Results: There was no significant difference in renal warm ischemia time, total operation time, intraoperative blood loss and postoperative complications between the presence or absence of vascular variation (P > 0.05). The total R.E.N.A.L. score was an independent risk factor for renal warm ischemia time greater than 20 min (P P < 0.05). Conclusion: CT three-dimensional reconstruction can clearly understand the anatomical location of the kidney, tumor and blood vessels before surgery, thereby reducing the occurrence of perioperative complications.
文摘患者,男性,54岁。头痛3月余,伴左侧肢体活动障碍半月余。患者3个月前无明显诱因出现头痛,半月前出现左侧肢体活动障碍,有进行性加重趋势,未出现抽搐、呕吐等情况。病程中,大小便正常,饮食睡眠一般,近期体质量未见明显减轻。体检:体温36.5℃、脉搏99次/分、呼吸20次/分、血压128/80 mm Hg(1 mm Hg≈0.133 k Pa)。
