大体积肾癌患者后腹腔镜肾癌根治术围术期心、肝及肾功能状态的变化观察
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摘要
目的:观察与探究大体积肾癌患者后腹腔镜肾癌根治术围术期心、肝及肾功能状态的变化情况。方法:选取2015年12月—2018年9月本院收治的52例大体积肾癌患者为研究对象,根据治疗方式的不同将其分为对照组(开放性肾癌根治术)26例及观察组(后腹腔镜肾癌根治术)26例。比较两组患者术前及术后24、48 h的心、肝及肾功能状态指标。结果:术前,两组的心、肝及肾功能状态指标比较,差异均无统计学意义(P>0.05),术后24、48 h观察组的心、肝及肾功能状态指标均低于对照组,差异均有统计学意义(P<0.05)。结论:大体积肾癌患者后腹腔镜肾癌根治术围术期心、肝及肾功能状态的波动相对小于开放性肾癌根治术,在大体积肾癌患者中的应用价值较高。
Objective:To observe and investigate the change situation of heart,liver and renal function state of patients with large renal cancer treated with retroperitoneal laparoscopic radical nephrectomy during the perioperative period.Method:52 patients with large renal cancer from December 2015 to September 2018 were chosen for the research,and they were divided into control group(open radical nephrectomy)26 cases and observation group(retroperitoneal laparoscopic radical nephrectomy)26 cases,according to the method of treatment.Then the heart,liver and renal function state indexes of two groups before the operation and at 24 h and48 h after the operation were compared.Result:The heart,liver and renal function state indexes of two groups before the operation were compared,the differences were not statistically significant(P>0.05),the heart,liver and renal function state indexes of observation group at 24 h and 48 h after the operation were all lower than those of control group,the differences were all statistically significant(P<0.05).Conclusion:The fluctuations of heart,liver and renal function state of patients with large renal cancer treated with retroperitoneal laparoscopic radical nephrectomy during the perioperative period are relatively smaller than those of patients with open radical nephrectomy,so its application value in the patients with large renal cancer is higher.
Objective:To observe and investigate the change situation of heart,liver and renal function state of patients with large renal cancer treated with retroperitoneal laparoscopic radical nephrectomy during the perioperative period.Method:52 patients with large renal cancer from December 2015 to September 2018 were chosen for the research,and they were divided into control group(open radical nephrectomy)26 cases and observation group(retroperitoneal laparoscopic radical nephrectomy)26 cases,according to the method of treatment.Then the heart,liver and renal function state indexes of two groups before the operation and at 24 h and48 h after the operation were compared.Result:The heart,liver and renal function state indexes of two groups before the operation were compared,the differences were not statistically significant(P>0.05),the heart,liver and renal function state indexes of observation group at 24 h and 48 h after the operation were all lower than those of control group,the differences were all statistically significant(P<0.05).Conclusion:The fluctuations of heart,liver and renal function state of patients with large renal cancer treated with retroperitoneal laparoscopic radical nephrectomy during the perioperative period are relatively smaller than those of patients with open radical nephrectomy,so its application value in the patients with large renal cancer is higher.
引文
[1]黄仁胜.不同入路腹腔镜手术治疗大体积肾癌的临床疗效和安全性分析[J].广西医学,2018,40(8):917-920.
[2]陈先国,冯振华,黄强,等.两种入路腹腔镜手术治疗大体积肾癌的临床疗效及安全性对比[J].临床医学工程,2018,25(5):571-572.
[3]焦湘.不同入路下腹腔镜手术治疗大体积肾癌的临床疗效对比[J].中国实用医刊,2017,44(15):37-39.
[4]石奇刚,孙永恒,任艳胜.腹腔镜下不同入路手术与开放式切除术治疗大体积肾癌的疗效及安全性分析[J].中国实用医刊,2017,44(3):39-41.
[5]Kawanishi H,Ito K,Kamido S,et al.Advantage of urological experience with both transperitoneal and retroperitoneal laparoscopy in lymph node biopsy for malignant lymphoma diagnosis[J].Investigative&Clinical Urology,2016,57(6):401-407.
[6]Ma L,Yu Y,Ge G,et al.Laparoscopic nephrectomy outside gerota fascia and en bloc ligation of the renal hilum for management of inflammatory renal diseases[J].International Braz J Urol,2018,44(2):280-287.
[7]吴朝阳.不同入路腹腔镜手术与开放手术治疗大体积肾癌临床疗效的对比研究[J].解放军医学杂志,2016,53(1):58-61.
[8]宋立杰,苗晓林,王顺新.经腹腔入路和经腹膜后入路腹腔镜手术治疗大体积肾癌疗效观察[J].陕西医学杂志,2016,45(7):848-849.
[9]Wang J,Yu S,Men C,et al.Transurethral electric coagulation combined with retroperitoneal laparoscopic nephroureterectomy for upper urinary urothelial carcinoma[J].International Surgery,2015,100(3):547-551.
[10]Shen H,Tu R,Wei L,et al.Comparison of the Clinical Efficacy of Retroperitoneal Laparoscopic Partial Nephrectomy and Radical Nephrectomy for Treating Small Renal Cell Carcinoma:Case Report and Literature Review[J].Iranian Red Crescent Medical Journal,2016,18(10):23912.
[11]秦光明,方利强.经腹膜后入路与经腹腔入路腹腔镜手术治疗大体积肾癌的疗效对比观察[J].腹腔镜外科杂志,2015,20(6):468-471.
[12]李平,刘志红.肾癌的手术治疗及残余肾功能评估与保护[J].肾脏病与透析肾移植杂志,2018,27(4):358-363.
[13]茆飞,顾硕,仲冰,等.后腹腔镜肾癌根治术对患者围术期肝、肾功能及心肌酶谱的影响[J].医学临床研究,2017,34(3):468-470.
[14]董洪超,王勤章,丁国富,等.T1b期肾癌患者经后腹腔镜肾部分切除术后的分肾功能分析[J].现代泌尿外科杂志,2017,22(3):181-184.
[15]Gahlawat S,Sood R,Sharma U,et al.Can preoperative clinicoradiological parameters predict the difficulty during laparoscopic retroperitoneal simple nephrectomy?-A prospective study[J].Urology Annals,2018,10(2):191-197.
[16]Binsaleh S,Alomar M,Madbouly K.Pfannenstiel incision for intact specimen extraction in laparoscopic transperitoneal radical nephrectomy:a longitudinal prospective outcome study[J].Clinics,2015,70(7):475-480.
[17]王忠尧,蔡德海,冯雄,等.保留肾单位手术对早期肾癌患者的肾功能及远期效果观察[J].中国地方病防治杂志,2017,32(5):584-584,586.
[18]赵国斌,李向东,孔雁萍,等.经腹膜后途径与经腹途径腹腔镜肾癌根治术对老年患者肝功能的影响[J].中国老年学杂志,2016,36(8):1930-1932.
[19]马力,张学能,李英,等.肾癌患者微创根治术后肾功能改变的动态观察[J].腹腔镜外科杂志,2015,20(3):229-232.
[20]张小安,胡岚亭,张宇,等.后腹腔镜保留肾单位手术治疗早期肾癌患者的术肾肾功能分析[J].现代生物医学进展,2014,14(18):3519-3523.
[21]张振兴,浦金贤,陆勇,等.肾癌根治术后连续观察肾功能变化的临床研究[J].中华外科杂志,2014,52(10):760-764.
[2]陈先国,冯振华,黄强,等.两种入路腹腔镜手术治疗大体积肾癌的临床疗效及安全性对比[J].临床医学工程,2018,25(5):571-572.
[3]焦湘.不同入路下腹腔镜手术治疗大体积肾癌的临床疗效对比[J].中国实用医刊,2017,44(15):37-39.
[4]石奇刚,孙永恒,任艳胜.腹腔镜下不同入路手术与开放式切除术治疗大体积肾癌的疗效及安全性分析[J].中国实用医刊,2017,44(3):39-41.
[5]Kawanishi H,Ito K,Kamido S,et al.Advantage of urological experience with both transperitoneal and retroperitoneal laparoscopy in lymph node biopsy for malignant lymphoma diagnosis[J].Investigative&Clinical Urology,2016,57(6):401-407.
[6]Ma L,Yu Y,Ge G,et al.Laparoscopic nephrectomy outside gerota fascia and en bloc ligation of the renal hilum for management of inflammatory renal diseases[J].International Braz J Urol,2018,44(2):280-287.
[7]吴朝阳.不同入路腹腔镜手术与开放手术治疗大体积肾癌临床疗效的对比研究[J].解放军医学杂志,2016,53(1):58-61.
[8]宋立杰,苗晓林,王顺新.经腹腔入路和经腹膜后入路腹腔镜手术治疗大体积肾癌疗效观察[J].陕西医学杂志,2016,45(7):848-849.
[9]Wang J,Yu S,Men C,et al.Transurethral electric coagulation combined with retroperitoneal laparoscopic nephroureterectomy for upper urinary urothelial carcinoma[J].International Surgery,2015,100(3):547-551.
[10]Shen H,Tu R,Wei L,et al.Comparison of the Clinical Efficacy of Retroperitoneal Laparoscopic Partial Nephrectomy and Radical Nephrectomy for Treating Small Renal Cell Carcinoma:Case Report and Literature Review[J].Iranian Red Crescent Medical Journal,2016,18(10):23912.
[11]秦光明,方利强.经腹膜后入路与经腹腔入路腹腔镜手术治疗大体积肾癌的疗效对比观察[J].腹腔镜外科杂志,2015,20(6):468-471.
[12]李平,刘志红.肾癌的手术治疗及残余肾功能评估与保护[J].肾脏病与透析肾移植杂志,2018,27(4):358-363.
[13]茆飞,顾硕,仲冰,等.后腹腔镜肾癌根治术对患者围术期肝、肾功能及心肌酶谱的影响[J].医学临床研究,2017,34(3):468-470.
[14]董洪超,王勤章,丁国富,等.T1b期肾癌患者经后腹腔镜肾部分切除术后的分肾功能分析[J].现代泌尿外科杂志,2017,22(3):181-184.
[15]Gahlawat S,Sood R,Sharma U,et al.Can preoperative clinicoradiological parameters predict the difficulty during laparoscopic retroperitoneal simple nephrectomy?-A prospective study[J].Urology Annals,2018,10(2):191-197.
[16]Binsaleh S,Alomar M,Madbouly K.Pfannenstiel incision for intact specimen extraction in laparoscopic transperitoneal radical nephrectomy:a longitudinal prospective outcome study[J].Clinics,2015,70(7):475-480.
[17]王忠尧,蔡德海,冯雄,等.保留肾单位手术对早期肾癌患者的肾功能及远期效果观察[J].中国地方病防治杂志,2017,32(5):584-584,586.
[18]赵国斌,李向东,孔雁萍,等.经腹膜后途径与经腹途径腹腔镜肾癌根治术对老年患者肝功能的影响[J].中国老年学杂志,2016,36(8):1930-1932.
[19]马力,张学能,李英,等.肾癌患者微创根治术后肾功能改变的动态观察[J].腹腔镜外科杂志,2015,20(3):229-232.
[20]张小安,胡岚亭,张宇,等.后腹腔镜保留肾单位手术治疗早期肾癌患者的术肾肾功能分析[J].现代生物医学进展,2014,14(18):3519-3523.
[21]张振兴,浦金贤,陆勇,等.肾癌根治术后连续观察肾功能变化的临床研究[J].中华外科杂志,2014,52(10):760-764.