后腹腔镜肾脏低温保护下部分切除术临床剖析.docVIP

后腹腔镜肾脏低温保护下部分切除术临床剖析 　　doi：10.3969/j.issn.1007-614x.2014.22.14 　　摘要目的：探索简单易行且安全有效的后腹腔镜下肾脏低温保护技术。方法：选取20例后腹腔镜肾脏低温保护下部分手术患者，分为对照组和研究组。研究组在后腹腔镜肾脏低温保护下行保留肾单位手术；对照组行常规后腹腔镜下保留肾单位手术。比较两组直肠温度和肾脏温度变化以及肾功能在手术前后的变化情况。结果：20例患者手术顺利；术后无继发出血、感染及漏尿。研究组冷缺血时间（45.2±5.8）分钟，平均最低肾脏温度（15.72±2.93）℃。研究组术前ECT示患肾肾小球滤过率（GFR）（33.57±1.07） mL/min，术后1个月患肾GFR（24.91±5.50）mL/min。对照组术前ECT示患肾GFR（35.65±0.45）mL/min，术后1个月患肾GFR（15.50±5.90）mL/min。患者术后随访1～16个月，未见局部复发、无转移。结论：后腹腔镜下肾脏低温保护技术简单易行、效果确切。 　　关键词腹腔镜；肾脏部分切除术；冷缺血 　　Analysis of partial resection under the retroperitoneoscopy kidney low temperature protection 　　Sun Dajun 　　The Traditional Chinese Medicine Hospital of Pingchang County，Sichuan 636400 　　AbstractObjective：To explore the simple，safe and effective retroperitoneoscopy kidney low temperature protection technology. Methods：20 cases with partial resection under the retroperitoneoscopy kidney low temperature protection were selected.They were divided into the control group and the research group.The research group were given nephron sparing surgery under the retroperitoneoscopy kidney low temperature protection.The control group were given nephron sparing surgery under the conventional retroperitoneoscopy.The rectal temperature and kidney temperature changes，renal function changes before and after operation of patients in two groups were compared.Results：20 cases had smooth operation.They had no secondary bleeding， infection and leakage of urine after operation.The cold ischemia time of the research group was （45.2±5.8） minutes；the average minimum kidney temperature was （15.72±2.93）℃.The preoperative ECT of the research group showed that the glomerular filtration rate（GFR） of the diseased kidney was （33.57±1.07） ml one minute；GFR of the diseased kidney of 1 month after operation was （24.91±5.50） ml one minute.The preoperative ECT of the control group showed that GFR of the diseased kidney was （35.65±0.45） ml one minute；GFR of the diseased kidney of 1 month after operation was （15.50±5.90） ml