摘要
目的:研究影响T_(1b)期肾占位患者肾部分切除术(PN)后早期肾功能的因素。方法:选取在青岛大学附属医院和复旦大学附属肿瘤医院行PN的63例患者,根据患者术前3d内和术后6个月的血肌酐值计算肾小球滤过率(GFR),按照术前及术后6个月GFR变化程度,将患者分为无/轻度损害组(A组)及重度损害组(B组),并分析患者年龄、性别、BMI、高血压病/糖尿病史、吸烟史、ECOG评分、病理、热缺血时间及出血量等因素对术后肾功能的影响。结果:B组患者年龄、BMI、高血压病、糖尿病、肿瘤直径、术前GFR、热缺血时间均明显大于A组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄(OR=2.96,95%CI:1.63~5.10)、BMI(OR=3.08,95%CI:1.78~7.01)、糖尿病(OR=1.60,95%CI:1.12~3.97)和术前GFR(OR=1.06,95%CI:1.03~1.10)为影响T_(1b)期肾占位PN术后早期肾功能的因素。结论:年龄、BMI、糖尿病、术前GFR可影响T_(1b)期肾占位PN术后早期肾功能恢复,积极的术前干预可预防术后慢性肾病(CKD)的发生。
Objective：To evaluate the influence factors of early renal function after partial nephrectomy（PN）in patients with stage T_（1b） renal masses.Method：A total of 63 patients who underwent PN in Affiliated Hospital of Qingdao University and Fudan University Shanghai Cancer Center were included in this study.The change of glomerular filtration rate（GFR）was calculated based on preoperative（within 3 days）and postoperative（6 months）serum creatinine.Clinicopathological factors,such as age,gender,height,weight,history of hypertension/diabetes,smoking status,ECOG score,pathology,the warm ischemia time and blood loss were analyzed to assess their influence on renal function decline.Result：According to the change of GFR,patients were divided into noneslight damage group（Group A）and severe damage group（Group B）.Age,body mass index（BMI）,proportion of hypertension and（or）diabetes,tumor size,preoperative GFR,postoperative GFR and warm ischemia time were significantly higher in group B than those in group A（P0.05）.Multivariate logistic regression analysis showed that age（OR=2.96,95%CI：1.63-5.10）,BMI（OR=3.08,95%CI：1.78-7.01）,diabetes（OR=1.60,95%CI：1.12-3.97）and preoperative GFR（OR=1.06,95%CI：1.03-1.10）were significantly associated with early renal function damage.Conclusion：Older age,higher BMI,history of diabetes and poor preoperative GFR might be risk factors of early renal function decline after PN for patients with stage T_（1b） renal masses.
作者
高哲民
张桂铭
官丰菊
夏瑞琴
朱耀
孙立江
GAO Zhemin;ZHANG Guiming;GUAN Fengju;XIA Ruiqin;ZHU Yao;SUN Lijiang(Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China;Operating Room, Affiliated Hospital of Qingdao University;Department of Urology, Fudan University Shanghai Cancer Center)
出处
《临床泌尿外科杂志》
2018年第4期299-301,共3页
Journal of Clinical Urology
基金
国家自然科学基金(编号81502195
81672512)
山东省医药卫生科技发展计划(编号2016WS0258)
关键词
肾占位
肾部分切除术
肾功能
肾小球滤过率
renal mass
partial nephrectomy
renal funetion
glomerular filtration rate
