选择性阻断肾动脉与全阻断肾动脉在腹腔镜肾肿瘤部分切除术中的疗效比较.docVIP

精品论文 参考文献 选择性阻断肾动脉与全阻断肾动脉在腹腔镜肾肿瘤部分切除术中的疗效比较 许言 诸禹平(通讯作者) 　　(安徽医科大学附属省立医院泌尿外科 230032) 　　【摘要】对比分析选择性阻断肾动脉在腹腔镜下肾部分切除术(laparoscopic partial nephrectomy，LPN)中治疗肾肿瘤临床应用价值。方法 回顾分析32例因肾肿瘤行手术治疗的患者的临床资料，其中15例行选择性阻断肾动脉下LPN；17例行全阻断下LPN。分析比较两组患者一般情况，手术情况及预后情况。结果 两组患者手术均顺利完成，无中转开放病例。其中选择性阻断组的阻断肾动脉时间、手术时间均高于全阻断组，术后全阻断组患者血肌酐水平较术前及选择性阻断组明显升高。随访6～24个月，全阻断组患者血肌酐平均水平明显高于选择性阻断组患者。随访期间，无一例复发或转移。结论 选择性阻断肾动脉虽增加了肾动脉阻断时间及手术时间，但术中出血量及风险并无增加，利于保护正常区域的肾单位，从而最大限度的保护肾功能。 　　【关键词】肾肿瘤 腹腔镜 肾部分切除术 肾动脉阻断 　　【中图分类号】R737.11 【文献标识码】A 【文章编号】2095-1752（2014）15-0172-02 　　A Clinical Comparison of the Efficacy on Renal Carcinoma with Selectivity Renal Artery Interrupted and Renal Artery Interrupted in Laparoscopic Partial Nephrectomy 　　【Abstract】 Objective:The effect and safety of the laparoscopic partial nephrectomy between selectivity renal artery interrupted and renal artery interrupted were analyzed, and a conclusion was given on the value of this new technology.Methods: 32 patients took the surgery of renal carcinoma, of which 15 took the selectivity renal artery interrupted and 17 took renal artery interrupted.The data were analyzed by comparing the difference between the two groups.Results:All surgeries work out successfully.For the results of the duration of the surgery and the length of time that renal artery got blocked, the selectivity renal artery interrupted group took longer than the renal artery interrupted group.The serum creatinine level of the renal artery interrupted patients after surgery was much higher than that before surgery, while there was no merely difference for the selectivity renal artery interrupted patients. The postoperative follow-up after 6 months to 24 months shows that the serum creatinine level of the renal artery interrupted patients after surgery was marked higher than those of selectivity renal artery interrupted patients. Whatrsquo;s more, there were no recurrence or metastasis during this period.Conclusio