后腹腔镜单侧肾上腺全切除术和部分切除术对患者反应速度影响的研究
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摘要
目的探讨经后腹腔腹腔镜单侧肾上腺全切除及部分切除术后对机体反应速度的影响。方法收集2015年8月至2017年5月我院收治的醛固酮瘤患者56例,其中女34例,男22例,年龄21~60岁;34例行单侧肾上腺全切术,22例行单侧肾上腺部分切除术。采取直尺垂直下降法测量并比较患者术前与术后3d、术后1个月、术后3个月的反应速度。结果 56例患者术后随访均无肿瘤复发,56例患者术后3个月内反应速度均较术前慢(P<0.05),但术后3个月开始单侧肾上腺部分切除组反应速度较单侧肾上腺全切组快,两组差异有统计学意义(P<0.05)。结论单侧肾上腺切除术后对患者反应速度有影响,且单侧肾上腺全切较肾上腺部分切除影响大。但由于本研究病例数较少、随访时间较短,具体影响程度及机制有待进一步随访研究。
Objective To investigate the effect of retroperitoneal laparoscopic adrenalectomy and partial adrenalectomy on the response rate of the body. Methods Fifty-six patients with aldosteronoma were collected from August 2015 to May 2017,including 34 females and 22 males,aged 21-60 years old.Thirty-four of them underwent total adrenalectomy and other 22 underwent partial adrenalectomy.The ruler vertical descent distance was collected to measure and compare the response rate of preoperative,postoperative three-day,one-month,three-month data. Results All the patients were followed up without tumor recurrence.All the patients' reaction rate in three months after operation was slow than that in the preoperative period(P<0.05),but from the third month after operation,the reaction rate showed obvious statistical difference between adrenalectomy group and partial adrenalectomy group(P<0.05). Conclusions Whether the adrenalectomy or partial resection can affect response rate,but adrenalectomy is more severe.Due to the limited number of cases and the short follow-up period,further studies were needed to understand the specific influences and mechanisms.
Objective To investigate the effect of retroperitoneal laparoscopic adrenalectomy and partial adrenalectomy on the response rate of the body. Methods Fifty-six patients with aldosteronoma were collected from August 2015 to May 2017,including 34 females and 22 males,aged 21-60 years old.Thirty-four of them underwent total adrenalectomy and other 22 underwent partial adrenalectomy.The ruler vertical descent distance was collected to measure and compare the response rate of preoperative,postoperative three-day,one-month,three-month data. Results All the patients were followed up without tumor recurrence.All the patients' reaction rate in three months after operation was slow than that in the preoperative period(P<0.05),but from the third month after operation,the reaction rate showed obvious statistical difference between adrenalectomy group and partial adrenalectomy group(P<0.05). Conclusions Whether the adrenalectomy or partial resection can affect response rate,but adrenalectomy is more severe.Due to the limited number of cases and the short follow-up period,further studies were needed to understand the specific influences and mechanisms.
引文
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[11]薛永平,肖维仁,王敏捷,等.后腹腔镜下肾上腺部分与全部切除术治疗单侧醛固酮腺瘤的对比研究[J].中国微创外科杂志,2017,17(3):207-212.
[12]唐勇,刘风梅,龚柳燕,等.MSCT对健康成人肾上腺体积的测量研究[J].医学影像学杂志,2015,25(7):1237-1239.
[13]Nakada T,Kubota Y,Sasagawa I,et al.Therapeutic outcome of primary aldosteronism:adrenalectomy versus enucleation of aldosterone-producing adenoma[J].J Urol,1995,153(6):1775-1780.
[2]Gagner M,Lacroix A,Bolte E,et al.Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma[J].N Engl J Med,1992,327(14):1033.
[3]王连渠,卜宏民,闫拥军,等.两种径路腹腔镜行肾上腺肿瘤手术的体会(附62例报告)[J].现代泌尿生殖肿瘤杂志,2015,7(1):52-53.
[4]Castillo OA,Vitagliano G,Secin FP,et al.Laparoscopic adrenalectomy for adrenal masses:does size matter?[J].Urology,2008,71(6):1138-1141.
[5]王肖,王建忠,邰胜,等.机器人腹腔镜手术在泌尿外科的临床经验分析(附300例报告)[J].安徽医科大学学报,2017,52(4):605-608.
[6]赵振华,胡卫列,郑东升,等.单侧肾上腺切除治疗原发性醛固酮增多症对侧肾上腺储备功能的评价分析[J].现代泌尿外科杂志,2014,19(11):728-731.
[7]李新涛,马鑫,吕香君,等.后腹腔镜肾上腺切除与部分肾上腺切除治疗醛固酮瘤的疗效比较[J].微创泌尿外科杂志,2013,2(5):317-319.
[8]Zouhal H,Jacob C,Delamarche P.Catecholamines and the effects of exercise,training and gender[J].Sports Med,2008,38(5):401-423.
[9]Krzeminski K,Kruk B,Nazar K,et al.Cardiovascular,metabolic and plasma catecholamine responses to passive and active exercises[J].J Physiol Pharmacol,2000,51(2):267-278.
[10]Cavka A,Stupin M,Panduric A,et al.Adrenergic System Activation Mediates Changes in Cardiovascular and Psychomotoric Reactions in Young Individuals after Red BullEnergy Drink Consumption[J].Int J Endocrinol,2015:751530.
[11]薛永平,肖维仁,王敏捷,等.后腹腔镜下肾上腺部分与全部切除术治疗单侧醛固酮腺瘤的对比研究[J].中国微创外科杂志,2017,17(3):207-212.
[12]唐勇,刘风梅,龚柳燕,等.MSCT对健康成人肾上腺体积的测量研究[J].医学影像学杂志,2015,25(7):1237-1239.
[13]Nakada T,Kubota Y,Sasagawa I,et al.Therapeutic outcome of primary aldosteronism:adrenalectomy versus enucleation of aldosterone-producing adenoma[J].J Urol,1995,153(6):1775-1780.