CAJ | 학술논문

目的：分析双侧散发性肾癌患者的临床疗效和生存状况。方法选择42例双侧散发性肾癌患者作为研究对象，行双侧肾手术治疗者29例，单侧手术治疗者8例，未进行手术治疗者5例，采用WHOQOL-100量表做为评估患者生存质量的标准。结果患者3年生存率为83．3％，双侧肾手术治疗与未行双侧肾手术治疗3年生存率分别为93．1％和61．5％，差异具有统计学意义（P＜0．05）；单因素分析结果显示：淋巴结转移、TNM分期及手术方式与患者预后相关（P＜0．05），Cox多因素回归分析结果显示：手术方式及TNM分期是影响患者预后的独立风险因素；行双侧肾脏手术者WHOQOL-100量表躯体功能、心理状态、独立性及总生活质量评分均显著优于未行双侧肾手术治疗者（P＜0．05）。结论双侧散发性肾癌患者的治疗应以双侧保留肾单位的肾切除术为主，手术方式及临床分期是影响患者预后的独立风险因素。
목적：분석쌍측산발성신암환자적림상료효화생존상황。방법선택42례쌍측산발성신암환자작위연구대상，행쌍측신수술치료자29례，단측수술치료자8례，미진행수술치료자5례，채용WHOQOL-100량표주위평고환자생존질량적표준。결과환자3년생존솔위83．3％，쌍측신수술치료여미행쌍측신수술치료3년생존솔분별위93．1％화61．5％，차이구유통계학의의（P＜0．05）；단인소분석결과현시：림파결전이、TNM분기급수술방식여환자예후상관（P＜0．05），Cox다인소회귀분석결과현시：수술방식급TNM분기시영향환자예후적독립풍험인소；행쌍측신장수술자WHOQOL-100량표구체공능、심리상태、독립성급총생활질량평분균현저우우미행쌍측신수술치료자（P＜0．05）。결론쌍측산발성신암환자적치료응이쌍측보류신단위적신절제술위주，수술방식급림상분기시영향환자예후적독립풍험인소。
Objective To analyze the effect and survival situation of sporadic bilateral renal cell carcinoma.Methods 42 cases of sporadic bilateral renal cell carcinoma were selected as research subjects.9 cases underwent bilateral operations,8 ca-ses underwent unilateral operation and 5 cases received no surgical treatment.WHOQOL-100 scale was used to evaluate life quali-ty.Results 3-year survival rate was 83.3%.The 3-year survival rates of patients with or without bilateral operations were 93.1%and 61.5%,there had significant difference (P<0.05);Single factor analysis showed that lymphatic metastasis,TNM stage and operation methods were related with prognosis ( P<0.05);Cox multivariate model showed that operation method and TNM stage were the independent factors influencing prognosis.Somatic function,psychology,independence and total life quality scores of WHOQOL-100 in patients underwent bilateral operations were superior to those without bilateral operations (P<0.05). Conclusion The nephron sparing bilateral surgery is a reasonable operation method for sporadic bilateral renal cell carcinoma, and operation method and TNM stage are the independent factors influencing prognosis.