摘要
目的探讨后腹腔镜肾部分切除术治疗早期肾癌患者的临床效果及对肾动脉阻断时间的影响。方法选取78例早期肾癌患者,随机分为对照组和研究组,每组39例。对照组进行开放保留肾单位肾部分切除术治疗,研究组进行后腹腔镜肾部分切除术治疗。对比两组手术相关指标(住院时间、拔管时间、术后下床时间、肾动脉阻断时间、引流量、出血量),治疗前后血肌酐、白细胞计数、前白蛋白水平,炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平。结果研究组住院时间(8.2±0.3)d、拔管时间(3.3±0.4)d、术后下床时间(3.2±0.5)d、肾动脉阻断时间(25.9±5.1)min均短于对照组的(14.1±1.2)d、(4.1±0.6)d、(7.3±2.4)d、(39.6±5.4)min,引流量(61.9±17.4)ml、出血量(116.4±10.1)ml均少于对照组的(92.2±25.8)、(443.6±15.3)ml,差异具有统计学意义(P<0.05)。治疗前,两组患者的血肌酐、白细胞计数、前白蛋白水平比较差异无统计学意义(P>0.05);治疗后,两组患者的血肌酐、白细胞计数水平均高于治疗前,前白蛋白水平均低于治疗前,但研究组血肌酐(96.5±13.2)μmol/L、白细胞计数(7.6±1.3)×10^(9)/L均低于对照组的(112.4±15.2)μmol/L、(10.8±1.5)×10^(9)/L,前白蛋白(219.2±25.5)mg/L高于对照组的(186.7±21.8)mg/L,差异具有统计学意义(P<0.05)。研究组患者的IL-6、TNF-α、CRP水平均低于对照组,差异具有统计学意义(P<0.05)。结论早期肾癌患者进行后腹腔镜肾部分切除术治疗的效果理想,可降低肾功能损伤,同时可缩短肾动脉阻断时间及住院时间,减少引流量与出血量,降低炎性因子水平。因此,后腹腔镜肾部分切除术治疗值得广泛应用。
Objective To discuss the clinical effect of retroperitoneal laparoscopic partial nephrectomy in patients with early-stage renal cancer and its influence on the time of renal artery occlusion.Methods A total of 78 patients with early-stage renal cancer were randomly divided into control group and research group,with 39 cases in each group.The control group was treated with open nephronsparing partial nephrectomy,and the research group was treated with retroperitoneal laparoscopic partial nephrectomy.Both groups were compared in terms of surgery-related indicators(hospitalization time,extubation time,postoperative off-bed time,renal artery occlusion time,drainage volume,blood loss),serum creatinine,white blood cell count,prealbumin level,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]levels before and after treatment.Results The hospitalization time(8.2±0.3)d,extubation time(3.3±0.4)d,postoperative off-bed time(3.2±0.5)d,and renal artery occlusion time(25.9±5.1)min in the research group were all shorter than(14.1±1.2)d,(4.1±0.6)d,(7.3±2.4)d,and(39.6±5.4)min in the control group;the drainage volume(61.9±17.4)ml and blood loss(116.4±10.1)ml were less than(92.2±25.8)and(443.6±15.3)ml in the control group;all the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in serum creatinine,white blood cell count and prealbumin level between the two groups(P>0.05).After treatment,the serum creatinine and white blood cell count in the two groups were higher than those before treatment in this group,and the prealbumin was lower than that before treatment in this group;the serum creatinine(96.5±13.2)μmol/L and white blood cell count(7.6±1.3)×10^(9)/L in the research group were lower than(112.4±15.2)μmol/L and(10.8±1.5)×10^(9)/L in the control group,and the prealbumin(219.2±25.5)mg/L was higher than(186.7±21.8)mg/L in the control group;all the differences were statistically significant(P<0.05)
作者
周密
ZHOU Mi(Department of Urology,Xingcheng People’s Hospital,Xingcheng 125100,China)
出处
《中国实用医药》
2022年第9期7-10,共4页
China Practical Medicine
关键词
早期肾癌
后腹腔镜肾部分切除术
临床效果
肾动脉阻断时间
Early-stage renal cancer
Retroperitoneal laparoscopic partial nephrectomy
Clinical effect
Time of renal artery occlusion
