摘要
目的探讨不同入路腹腔镜下肾盂成形术对肾盂输尿管连接部梗阻患者的疗效及对胃肠功能的影响。方法选取2015年6月～2018年1月期间本院收治的肾盂输尿管连接部梗阻患者84例为研究对象,根据手术入路的不同分为A组与B组,每组各42例。两组均进行腹腔镜下肾盂成形术治疗,A组采用经腹腔途径手术,B组采用经后腹腔途径手术。比较两组患者的出血量、手术时间、住院时间、治疗前后的肾盂压力、肾盂分离度、肾皮质厚度、肾功能指标、胃肠激素水平。结果 B组出血量小于A组(P<0.05),手术时间及住院时间均短于A组(P<0.05);治疗后两组的肾盂压力、肾盂分离度、肾皮质厚度及肾功能指标均优于治疗前(P<0.05),但两组差异无统计学意义(P>0.05),B组治疗后的胃肠激素水平均优于A组(P<0.05)。结论经后腹腔途径腹腔镜下肾盂成形术对肾盂输尿管连接部梗阻患者的疗效较好,对胃肠功能的不良影响相对更小,在本类患者中的应用价值相对更高。
Objective To observe and compare the effect of different approaches of laparoscopic pyeloplasty in the patients with ureteropelvic junction obstruction and influence for the gastrointestinal function.Methods 84 patients with ureteropelvic junction obstruction in our hospital from June 2015 to January 2018 were chosen for the study,and they were divided into two groups with 42 cases in each group according to the difference of surgical approaches.The two groups were all treated with laparoscopic pyeloplasty.The group A were treated by transperitoneal approach.The group B were treated by retroperitoneal approach.Then the blood loss,operation time,hospitalization time,renal pelvis pressure,renal pelvis separation,,renal cortical thickness,renal function and gastrointestinal hormone levels before and after the treatment of two groups were compared.Results The blood loss of group B was less than that of group A(P<0.05).The operation time and hospitalization time were shorter than those of group A(P<0.05).The renal pelvis pressure,renal pelvis separation,renal cortical thickness and renal function indexes of two groups after the treatment were all better than those before the treatment(P<0.05).The gastrointestinal hormone levels of group B were all better than those of group A(P<0.05).Conclusion The effect of different approaches of laparoscopic pyeloplasty in the patients with ureteropelvic junction obstruction are better,and its bad influence for the gastrointestinal function are relatively smaller,so its application value in these patients is relatively higher.
作者
沈宏峰
朱其聪
黄尉
刘贤志
李威
何耿
覃振昌
SHEN Hongfeng;ZHU Qicong;HUANG Wei;LIU Xianzhi;LI Wei;HE Geng;QIN Zhenchang(Department of Urology,Hospital 187 of PLA,Haikou 571159,China)
出处
《西部医学》
2019年第2期241-244,249,共5页
Medical Journal of West China
基金
海南省卫生厅科学研究课题(2011-98)
关键词
肾盂成形术
肾盂输尿管连接部梗阻
经腹腔途径
经后腹腔途径
胃肠功能
Transperitoneal approach
Retroperitoneal approach
Laparoscopic pyeloplasty
Ureteropelvic junction obstruction
Gastrointestinal function
