CAJ | 학술논문

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。
대비분석선택성조단신동맥재복강경하신부분절제술(laparoscopic partial nephrectomy，LPN)중치료신종류림상응용개치。방법회고분석32례인신종류행수술치료적환자적림상자료，기중15례행선택성조단신동맥하LPN；17례행전조단하LPN。분석비교량조환자일반정황，수술정황급예후정황。결과량조환자수술균순리완성，무중전개방병례。기중선택성조단조적조단신동맥시간、수술시간균고우전조단조，술후전조단조환자혈기항수평교술전급선택성조단조명현승고。수방6～24개월，전조단조환자혈기항평균수평명현고우선택성조단조환자。수방기간，무일례복발혹전이。결론선택성조단신동맥수증가료신동맥조단시간급수술시간，단술중출혈량급풍험병무증가，리우보호정상구역적신단위，종이최대한도적보호신공능。
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:Al surgeries work out successful y.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 fol ow-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. What’s more, there were no recurrence or metastasis during this period.Conclusion:It would increase the duration of the surgery and the length of time that renal artery got blocked, but selectivity renal artery interrupted can protect the normal area and the renal function, without any other potential risks and increase of the amount of bleeding.