后腹腔镜包膜下肾切除技术治疗无功能肾附36例报导.docVIP

后腹腔镜包膜下肾切除技术治疗无功能肾附36例报导 　　【摘要】 目的：分析后腹腔镜包膜下肾切除技术治疗无功能肾的效果。方法：选取本院泌尿外科2010年2月-2014年1月采用后腹腔镜包膜下肾切除术治疗的36例无功能肾患者作为试验组，同期36例采用开放手术治疗的无功能肾患者作为对照组。比较两组手术情况及术后并发症发生情况。结果：所有患者术后均达到一期愈合。试验组手术时间长于对照组，住院时间及术中出血量均少于对照组，术后并发症发生率明显低于对照组，两组比较差异均有统计学意义（P0.05）。结论：后腹腔镜包膜下肾切除技术治疗无功能肾疗效好、创伤小、并发症少、恢复快，具有良好的应用前景。 　　【关键词】 后腹腔镜； 包膜下肾切除； 无功能肾； 治疗效果 　　【Abstract】 Objective：To analyze the effect of subcapsular nephrectomy with retroperitoneoscopic in the treatment of non function kidney.Method： 36 non function kidney patients who were treated by subcapsular nephrectomy with retroperitoneoscopic in our hospital from February 2010 to January 2014 were selected as the experimental group，36 non function kidney patients who were treated with open surgical operation were selected as the control group at the same time.The operation condition and the occurrence of postoperative complications were compared between the two groups.Result：All patients reached healing by first intention.The operative time， hospitalization time， intraoperative bleeding and the occurrence of postoperative complications of the experimental group were better than those of the control group，the differences above were statistically significant（P0.05）.Conclusion：Subcapsular nephrectomy with retroperitoneoscopic in the treatment of non function kidney has the advantages of good curative effect，small trauma， fewer complications and quick recovery，it has a good application prospect. 　　【Key words】 Retroperitoneoscopic； Subcapsular nephrectomy； Non function kidney； Therapeutic effect 　　First-author’s address：The People’s Hospital of Pingxiang City，Pingxiang 337000，China 　　doi：10.3969/j.issn.1674-4985.2015.25.006 　　感染性无功能肾的临床治疗较棘手，由于感染导致肾周组织发生广泛而致密的粘连，肾周组织与肾包膜无明显界限，强行分离易误入肾实质而导致大量出血。手术野出血多引起手术难度增加。有时腹膜间位脏器如十二指肠、结肠和靠近腹膜后的脏器如胰腺、脾脏等与肾周组织粘连，在解剖层次不清时损伤风险较大。在包膜下行肾切除术可避开粘连，在肾包膜和肾实质之间将无功能肾游离后切除，手术效果较满意[1]。本文分析了后腹腔镜包膜下肾切除技术和开放手术治疗无功能肾的效果，现将研究结果分析报道如下。 　　1 资料与方法 　　1.1 一般资料 选取本院泌尿外科2010年2月 　　-2014年1月采用后腹腔镜包膜下肾切除术治疗的36例无功能肾患者作为试验组，其