中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
22期
9941-9944
,共4页
肾肿瘤%腹腔镜外科手术%保留肾单位手术%生存质量
腎腫瘤%腹腔鏡外科手術%保留腎單位手術%生存質量
신종류%복강경외과수술%보류신단위수술%생존질량
Kidney neoplasms%Laparoscopic surgical procedures%Partial nephrectomy%Quality of life
目的：评价腹腔镜与开放保留肾单位手术在干预肾脏占位性疾病的疗效及远期生存质量方面的作用。方法纳入2009年6月至2011年6月在我院行肾部分切除术的肾脏占位性疾病患者65例，其中试验组（腹腔镜肾部分切除术组）35例和对照组（开放肾部分切除术组）30例。比较两组手术时间、术中肾蒂阻断时间、失血量、术后3d内血肌酐水平、胃肠功能恢复时间、术后并发症、住院时间等各项指标及远期生存质量量表SF-36评分。结果65例手术均顺利完成。腹腔镜组较对照组手术出血量少[（50.6±20.3）ml vs.（308.6±95.6）ml]，胃肠功能恢复快[（2.7±0.8）d vs.（3.8±1.3）d]，住院时间短[（13.2±3.1）d vs.（16.4±4.3）d]；手术时间[（122.1±55.6）min vs.（96.2±50.5）min]和术中肾蒂阻断时间[（28.3±2.5）min vs.（18.3±8.2）min]较长，差异均有统计学意义（P＜0.05）。术后2年远期生存质量量表评分较对照组在情感职能（50.4±20.2 vs.42.7±11.3）、活力（56.3±23.2 vs.40.2±10.9）等项目上有一定提高（P＜0.05）。结论本研究显示腹腔镜手术与开放手术相比具有出血少，恢复快，住院时间短等优势。但是手术时间和术中肾脏血供阻断时间较长。
目的：評價腹腔鏡與開放保留腎單位手術在榦預腎髒佔位性疾病的療效及遠期生存質量方麵的作用。方法納入2009年6月至2011年6月在我院行腎部分切除術的腎髒佔位性疾病患者65例，其中試驗組（腹腔鏡腎部分切除術組）35例和對照組（開放腎部分切除術組）30例。比較兩組手術時間、術中腎蒂阻斷時間、失血量、術後3d內血肌酐水平、胃腸功能恢複時間、術後併髮癥、住院時間等各項指標及遠期生存質量量錶SF-36評分。結果65例手術均順利完成。腹腔鏡組較對照組手術齣血量少[（50.6±20.3）ml vs.（308.6±95.6）ml]，胃腸功能恢複快[（2.7±0.8）d vs.（3.8±1.3）d]，住院時間短[（13.2±3.1）d vs.（16.4±4.3）d]；手術時間[（122.1±55.6）min vs.（96.2±50.5）min]和術中腎蒂阻斷時間[（28.3±2.5）min vs.（18.3±8.2）min]較長，差異均有統計學意義（P＜0.05）。術後2年遠期生存質量量錶評分較對照組在情感職能（50.4±20.2 vs.42.7±11.3）、活力（56.3±23.2 vs.40.2±10.9）等項目上有一定提高（P＜0.05）。結論本研究顯示腹腔鏡手術與開放手術相比具有齣血少，恢複快，住院時間短等優勢。但是手術時間和術中腎髒血供阻斷時間較長。
목적：평개복강경여개방보류신단위수술재간예신장점위성질병적료효급원기생존질량방면적작용。방법납입2009년6월지2011년6월재아원행신부분절제술적신장점위성질병환자65례，기중시험조（복강경신부분절제술조）35례화대조조（개방신부분절제술조）30례。비교량조수술시간、술중신체조단시간、실혈량、술후3d내혈기항수평、위장공능회복시간、술후병발증、주원시간등각항지표급원기생존질량량표SF-36평분。결과65례수술균순리완성。복강경조교대조조수술출혈량소[（50.6±20.3）ml vs.（308.6±95.6）ml]，위장공능회복쾌[（2.7±0.8）d vs.（3.8±1.3）d]，주원시간단[（13.2±3.1）d vs.（16.4±4.3）d]；수술시간[（122.1±55.6）min vs.（96.2±50.5）min]화술중신체조단시간[（28.3±2.5）min vs.（18.3±8.2）min]교장，차이균유통계학의의（P＜0.05）。술후2년원기생존질량량표평분교대조조재정감직능（50.4±20.2 vs.42.7±11.3）、활력（56.3±23.2 vs.40.2±10.9）등항목상유일정제고（P＜0.05）。결론본연구현시복강경수술여개방수술상비구유출혈소，회복쾌，주원시간단등우세。단시수술시간화술중신장혈공조단시간교장。
Objective To analysis clinical effects of laparoscopic partial nephrectomy and open partial nephrectomy. Methods 65 patients with renal space occupying lesions received partial nephrectomy in our hospital were selected from Jun 2009 to Jun 2011. They were divided into experimental group (n=35) and control group (n=30). Variable analysis included operative time, intraoperative renal pedicle clamping time, amount of blood loss, serum creatinine level in 3 days, the recovery time of gastrointestinal function, postoperative complications, hospitalization time and SF-36 Scale score. Results All 65 patients were operated successfully. Compared with open group, the mean blood loss of laparoscopic group was less than which in the open group. Laparoscopic group had a faster recovery of gastrointestinal function and a shorter hospital stay. While compared with open group, laparoscopic group had a longer operative time and intraoperative renal pedicle clamping time. Meanwhile, the life quality of long-term has improved in some aspects. Conclusion Compared with open surgery, laparoscopic partial nephrectomy had less bleeding, faster recovery, shorter hospital stay and other advantages,but the operative time and intraoperative blood supply to the kidney blocked a long time.
