膈肌内侧弓状韧带在后腹腔镜肾切除术中的应用效果.docVIP

膈肌内侧弓状韧带在后腹腔镜肾切除术中的应用效果 肖尚文 张涛 安康市中医医院 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探讨膈肌内侧弓状韧带在后腹腔镜肾切除术中的应用效果。方法 选取我院2015年6月至2016年12月收治的38例行肾切除术的患者, 其中肾癌患者24例, 多因素导致肾功能严重障碍、肾萎缩患者14例, 上述38例患者均通过膈肌内侧弓状韧带寻找肾动脉, 并予以肾脏游离, 观察38例行肾切除术患者的肾动脉显露时间、手术时间、出血量及中转情况。结果38例予以肾切除术患者的肾动脉显露时间为 (16.87±3.41) min, 肾切除手术时间为 (86.27±6.18) min, 出血量为 (35.51±11.32) m L, 中途未予以输血措施, 无中转开放。结论 后腹腔镜下可将膈肌内侧弓状韧带清楚显示, 其内弓状韧带于水平中线方向行走, 正对于肾动脉, 于内侧弓状韧带为定位靶标, 可迅速找到肾血管, 故临床中遵循“宁少勿多”原则将肾后间隙游离, 可将肾血管清晰显露, 以减少操作通道数量, 其膈肌内侧弓状韧带在后腹腔镜肾切除术中的应用效果显著, 可借此迅速找到肾动脉, 减少手术时间, 降低术中出血量, 保证患者的生命安全。 关键词： 后腹腔镜肾切除术; 膈肌内侧弓状韧带; 手术时间; 术中出血; 作者简介：肖尚文 (1976-) , 男, 汉族, 陕西安康人, 副主任医师。研究方向:泌尿外科及男科腹腔镜技术。 作者简介：张涛, E-mail:281062359@. Application effect of the diaphragm medial arcuate ligament in retroperitoneal laparoscopic nephrectomy XIAO Shang-wen ZHANG Tao Traditional Chinese Medicine Hospital of Ankang; Abstract： Objective To investigate the application effect of the diaphragm medial arcuate ligament in retroperitoneal laparoscopic nephrectomy. Methods A total of 38 patients admitted in our hospital from June 2015 to December 2016 were enrolled in the study. Among them, 24 patients were with renal cell carcinoma, and 14 patients were with severe renal dysfunction or renal atrophy leaded by various factors. The renal arteries of the above 38 patients was found through the medial arcuate ligament of the diaphragm, and the kidneys were separated. The time of renal artery exposure, nephrectomy operation time, intraoperative blood loss and incidence of transfer of 38 patients who received retroperitoneal laparoscopic nephrectomy were observed. Results The time of renal artery exposure was (16.87 ±3.41) min, nephrectomy operation time was (86.27±6.18) min, and the intraoperative blood loss was (35.51 ±11.32) m L. No blood transfusions and no transfer were found. Conclusion The retroperitoneal lacrimal ligament can clearly show the internal ligament of the diaphragm, which is in the directio