保留肾单位手术对肾癌患者肾功能和生活质量的影响
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摘要
目的探讨保留肾单位手术对肾癌患者肾功能和生活质量的影响。方法选取90例肾癌患者作为研究对象,依据随机数字表法将患者分为保留肾单位组(行保留肾单位手术)和根治性肾切除术组(行根治性肾切除手术),每组45例。比较两组患者术前及术后6个月的血肌酐和尿素氮水平及生活质量,采用Pearson法分析血肌酐和尿素氮水平与生活质量的相关性。结果术后6个月,根治性肾切除术组患者的血肌酐和尿素氮水平均高于本组术前,保留肾单位组患者的血肌酐和尿素氮水平均低于根治性肾切除术组,差异均有统计学意义(P<0.05)。术后6个月,两组患者环境领域、社会领域、心理领域、生理领域以及总体健康评分均较本组术前升高,且保留肾单位组患者的上述评分均高于根治性肾切除术组,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,保留肾单位组患者的血肌酐和尿素氮水平与环境领域、社会领域、心理领域、生理领域以及总体健康评分均呈负相关(P<0.05)。结论肾癌患者行保留肾单位手术后的肾功能与生活质量有密切关系,保留肾单位手术有助于改善肾癌患者的肾功能与生活质量。
Objective To analyze the renal function and quality of life(QOL) after nephron-sparing surgery in patients with renal carcinoma. Method Ninety patients with renal carcinoma treated were enrolled in the study. According to a random number table, this cohor of patients was divided into nephron-sparing surgery group(n=45) and radical nephrectomy group(n=45), respectively. The levels of serum creatinine and urea nitrogen, and QOL were compared between the two groups before and 6 months after operation, and the correlation between serum creatinine, urea nitrogen and QOL was analyzed by Pearson correlation analysis. Result In 6 months after operation, the serum creatinine and urea nitrogen levels were increased in radical nephrectomy group, while were lower in nephron-sparing surgery group compared with radical nephrectomy group, the differences were statistically significant(P<0.05). In 6 months after operation, the environmental, social, psychological, physiological and general health scores were improved in both groups, and these scores were significantly higher in nephron-sparing surgery group than those in radical nephrectomy group, indicating statistically significant difference(P<0.05). Pearson correlation analysis showed that, the serum creatinine and urea nitrogen levels were negatively correlated with environmental, social, psychological, physiological and overall health scores(P<0.05). Conclusion The renal function is closely related to the QOL of patients with renal carcinoma after nephron-sparing surgery, which is helpful in improving the renal function and QOL in patients with renal carcinoma.
Objective To analyze the renal function and quality of life(QOL) after nephron-sparing surgery in patients with renal carcinoma. Method Ninety patients with renal carcinoma treated were enrolled in the study. According to a random number table, this cohor of patients was divided into nephron-sparing surgery group(n=45) and radical nephrectomy group(n=45), respectively. The levels of serum creatinine and urea nitrogen, and QOL were compared between the two groups before and 6 months after operation, and the correlation between serum creatinine, urea nitrogen and QOL was analyzed by Pearson correlation analysis. Result In 6 months after operation, the serum creatinine and urea nitrogen levels were increased in radical nephrectomy group, while were lower in nephron-sparing surgery group compared with radical nephrectomy group, the differences were statistically significant(P<0.05). In 6 months after operation, the environmental, social, psychological, physiological and general health scores were improved in both groups, and these scores were significantly higher in nephron-sparing surgery group than those in radical nephrectomy group, indicating statistically significant difference(P<0.05). Pearson correlation analysis showed that, the serum creatinine and urea nitrogen levels were negatively correlated with environmental, social, psychological, physiological and overall health scores(P<0.05). Conclusion The renal function is closely related to the QOL of patients with renal carcinoma after nephron-sparing surgery, which is helpful in improving the renal function and QOL in patients with renal carcinoma.
引文
[1]金宗兰,胡少华,陈萍萍,等.叙事医学模式对肾癌根治术患者康复效果影响的随机对照试验研究[J].中国实用护理杂志,2017,33(20):1525-1529.
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[5]谢月,陈淑华,姜建军,等.肾细胞癌根治性切除术后患者实施团队管理式延续护理的效果[J].护理管理杂志,2017,17(4):268-270.
[6]The World Health Organisation Quality of Life Group.The World Health Organization quality of life assessment(WAOQOL):development and general psychometric properties[J].Soc Sci Med,1998,46(12):1569-1585.
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[10]龚娟,卢童.快速康复外科护理在后腹腔镜下保留肾单位肾部分切除术中的应用[J].现代泌尿生殖肿瘤杂志,2018,10(2):123-124.
[11]Mistretta FA,Mazzone E,Knipper S,et al.Benefit of nephron sparing surgery translates into lower cancer specific mortality in patients with localized renal cell carcinoma[J].Ann Transl Med,2018,6(Suppl 2):S104.
[12]李晓红.腹腔镜保留肾单位肾肿瘤切除术与根治性肾切除术对肾细胞癌患者术后肾功能及生存质量影响分析[J].临床误诊误治,2017,30(2):95-98.
[13]贾军琪,张培波,林建群,等.腹腔镜下保留肾单位肾肿瘤切除术的疗效及对患者生存质量的影响[J].实用癌症杂志,2017,32(12):2009-2011;2016.
[14]周惠雅.舒适护理对提高恶性肿瘤患者生活质量的作用[J].国际护理学杂志,2017,36(22):3104-3106;3153.
[15]王丽双,邹婷婷,孙媛,等.护理干预对中晚期恶性肿瘤病人生存质量的影响[J].蚌埠医学院学报,2017,42(4):532-535.
[16]Nerli RB,Ghagane SC,Ram P,et al.Nephron sparing surgery for synchronous bilateral wilms-operative steps[J].Indian J Surg Oncol,2018,9(4):601-604.
[17]Ceccanti S,Cozzi F,Cervellone A,et al.Volume and function of the operated kidney after nephron-sparing surgery for unilateral renal tumor[J].J Pediatr Surg,2019,54(2):326-330.
[2]Zhu X,Yang X,Hu X,et al.Retroperitoneoscopic versus open surgical radical nephrectomy for 152 Chinese patients with large renal cell carcinoma in clinical stage cT2 or cT3a:a long-term retrospective comparison[J].J Cancer Res Ther,2016,12(2):805-810.
[3]Laganosky DD,Filson CP,Master VA.Surgical margins in nephron-sparing surgery for renal cell carcinoma[J].Curr Urol Rep,2017,18(1):8.
[4]Ebbing J,Menzel F,Frumento P,et al.Outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer[J].BMC Nephrol,2019,20(1):40.
[5]谢月,陈淑华,姜建军,等.肾细胞癌根治性切除术后患者实施团队管理式延续护理的效果[J].护理管理杂志,2017,17(4):268-270.
[6]The World Health Organisation Quality of Life Group.The World Health Organization quality of life assessment(WAOQOL):development and general psychometric properties[J].Soc Sci Med,1998,46(12):1569-1585.
[7]Li G,Zhu DS,Lang ZQ,et al.Classification of positive surgical margins and tumor recurrence after nephron-sparing surgery for small renal masses[J].Cancer Manag Res,2018,10:6591-6598.
[8]洪旭伟,唐开强,庞诗语,等.3D腹腔镜技术在肾癌手术治疗中的应用进展[J].广东医学,2016,37(2):161-163.
[9]吴海严,程文.保留肾单位的肾癌手术研究进展[J].医学综述,2017,23(11):2150-2154.
[10]龚娟,卢童.快速康复外科护理在后腹腔镜下保留肾单位肾部分切除术中的应用[J].现代泌尿生殖肿瘤杂志,2018,10(2):123-124.
[11]Mistretta FA,Mazzone E,Knipper S,et al.Benefit of nephron sparing surgery translates into lower cancer specific mortality in patients with localized renal cell carcinoma[J].Ann Transl Med,2018,6(Suppl 2):S104.
[12]李晓红.腹腔镜保留肾单位肾肿瘤切除术与根治性肾切除术对肾细胞癌患者术后肾功能及生存质量影响分析[J].临床误诊误治,2017,30(2):95-98.
[13]贾军琪,张培波,林建群,等.腹腔镜下保留肾单位肾肿瘤切除术的疗效及对患者生存质量的影响[J].实用癌症杂志,2017,32(12):2009-2011;2016.
[14]周惠雅.舒适护理对提高恶性肿瘤患者生活质量的作用[J].国际护理学杂志,2017,36(22):3104-3106;3153.
[15]王丽双,邹婷婷,孙媛,等.护理干预对中晚期恶性肿瘤病人生存质量的影响[J].蚌埠医学院学报,2017,42(4):532-535.
[16]Nerli RB,Ghagane SC,Ram P,et al.Nephron sparing surgery for synchronous bilateral wilms-operative steps[J].Indian J Surg Oncol,2018,9(4):601-604.
[17]Ceccanti S,Cozzi F,Cervellone A,et al.Volume and function of the operated kidney after nephron-sparing surgery for unilateral renal tumor[J].J Pediatr Surg,2019,54(2):326-330.