中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
12期
125-128
,共4页
微波消融%腹腔镜%肾肿瘤
微波消融%腹腔鏡%腎腫瘤
미파소융%복강경%신종류
Microwave ablation%Laparoscope%Renal tumor
目的：研究腹腔镜下微波消融（MWA）辅助治疗小肾癌的临床疗效。方法：选取2012年5月-2014年10月应用腹腔镜下微波消融辅助治疗的小肾癌患者15例，其中不阻断肾蒂，肿瘤小于3 cm者直接行微波消融；肿瘤大于3 cm者于肿瘤周围行微波消融，形成无血供平面，再行肾部分切除术，记录手术时间、出血量、围术期Hb、SCr及患侧肾GFR变化，统计住院时间、术后并发症率，观察肿瘤预后。结果：所有患者均成功手术，无中转开放者。围术期Hb、SCr、患侧肾GFR与术前比较差异均无统计学意义（P>0.05）。手术时间（103±15）min，手术出血量（72±25）mL，术后住院时间（5±2）d。术后并发症率13.3%（2/15），其中1例发热，1例患侧疼痛不适，休息后自行缓解，无术后漏尿患者。所有患者术后随访平均18.7（6~32）个月，分别于术后1、3、6个月行增强CT，无肿瘤复发及死亡病例。结论：腹腔镜下微波消融辅助治疗小肾癌安全有效，出血少，术后恢复快，并发症少，有望成为T1期肾癌的有效治疗方式之一。
目的：研究腹腔鏡下微波消融（MWA）輔助治療小腎癌的臨床療效。方法：選取2012年5月-2014年10月應用腹腔鏡下微波消融輔助治療的小腎癌患者15例，其中不阻斷腎蒂，腫瘤小于3 cm者直接行微波消融；腫瘤大于3 cm者于腫瘤週圍行微波消融，形成無血供平麵，再行腎部分切除術，記錄手術時間、齣血量、圍術期Hb、SCr及患側腎GFR變化，統計住院時間、術後併髮癥率，觀察腫瘤預後。結果：所有患者均成功手術，無中轉開放者。圍術期Hb、SCr、患側腎GFR與術前比較差異均無統計學意義（P>0.05）。手術時間（103±15）min，手術齣血量（72±25）mL，術後住院時間（5±2）d。術後併髮癥率13.3%（2/15），其中1例髮熱，1例患側疼痛不適，休息後自行緩解，無術後漏尿患者。所有患者術後隨訪平均18.7（6~32）箇月，分彆于術後1、3、6箇月行增彊CT，無腫瘤複髮及死亡病例。結論：腹腔鏡下微波消融輔助治療小腎癌安全有效，齣血少，術後恢複快，併髮癥少，有望成為T1期腎癌的有效治療方式之一。
목적：연구복강경하미파소융（MWA）보조치료소신암적림상료효。방법：선취2012년5월-2014년10월응용복강경하미파소융보조치료적소신암환자15례，기중불조단신체，종류소우3 cm자직접행미파소융；종류대우3 cm자우종류주위행미파소융，형성무혈공평면，재행신부분절제술，기록수술시간、출혈량、위술기Hb、SCr급환측신GFR변화，통계주원시간、술후병발증솔，관찰종류예후。결과：소유환자균성공수술，무중전개방자。위술기Hb、SCr、환측신GFR여술전비교차이균무통계학의의（P>0.05）。수술시간（103±15）min，수술출혈량（72±25）mL，술후주원시간（5±2）d。술후병발증솔13.3%（2/15），기중1례발열，1례환측동통불괄，휴식후자행완해，무술후루뇨환자。소유환자술후수방평균18.7（6~32）개월，분별우술후1、3、6개월행증강CT，무종류복발급사망병례。결론：복강경하미파소융보조치료소신암안전유효，출혈소，술후회복쾌，병발증소，유망성위T1기신암적유효치료방식지일。
Objective:To assess the clinical efficacy of laparoscopic microwave ablation (LMA) in the treatment of small renal carcinoma.Method:From May 2012 to Oct 2014, the LMA was performed for 15 small renal carcinoma. The renal pedicle was not blocked during operation, microwave ablation was carried out for tumors smaller than 3cm, while laparoscopic microwave ablation partial nephrectomy(LMAPN) was performed for tumors 3-4 cm.The operationtime, blood loss, changes of Hb, SCr and GFR before and after operation, postoperative hospital stay, complication rates and tumor prognosis of these cases were recorded and analyzed.Result:All cases were operated successfully, no case was converted to laparotomy.There was no significant change of Hb, SCr and GFR after operations(P>0.05).The operation time was (103±15)min, the blood loss was (72±25)ml, the postoperative hospital stay was (5±2)d. The complication rate was 13.3%(2/15), with 1 case of fever and 1 case of pain with no case of urine leakage.Patients were followed up for 18.7(6-32)months.Enhanced CT was taken by 1 month,3 month and 6 month after operation, there was no tumor recurrence and death cases.Conclusion:LMA for small renal carcinoma is safe and effective with less bleeding,quick recovery and low complication rate.It is hopefully to become one of an effective way for treating T1 stage renal carcinoma.
