CAJ | 학술논문

目的评价腹腔镜与开放性两种部分切除术对肾脏肿瘤的治疗效果及其安全性.方法选择2012年8月至2014年6月于我院进行腹腔镜部分肾切除术(LPN)的49例肾脏肿瘤患者为LPN组,同期进行开放性部分肾切除术(OPN)的肾脏肿瘤患者50例为OPN组,对比两组手术基本情况、并发症情况及预后效果等,综合评价其优劣性.结果两组手术用时相当,差异无统计学意义(P＞0.05).LPN组的术中出血量低于OPN组,但肾动脉阻断时间长于OPN,差异均有统计学意义(P＜ 0.05).两组住院费用比较差异无统计学意义(P＞0.05),LPN组的术后住院时间、疼痛持续时间、术后止痛药用量、下床活动时间、肠道功能恢复时间、拔出引流管时间均低于OPN组,差异有统计学意义(P＜0.05).术后1个月两组血清肌酐、尿素、尿酸含量的变化相当,差异无统计学意义(P＞0.05).LPN组胸/腹膜损伤率、肾周血肿率、切口感染率均要优于OPN组,差异有统计学意义(P＜ 0.05).结论 LPN具有针对性强、创伤小、恢复快、并发症少的优点,可作为肾脏小肿瘤的首选治疗方法.
목적 평개복강경여개방성량충부분절제술대신장종류적치료효과급기안전성.방법 선택2012년8월지2014년6월우아원진행복강경부분신절제술(LPN)적49례신장종류환자위LPN조,동기진행개방성부분신절제술(OPN)적신장종류환자50례위OPN조,대비량조수술기본정황、병발증정황급예후효과등,종합평개기우렬성.결과 량조수술용시상당,차이무통계학의의(P＞0.05).LPN조적술중출혈량저우OPN조,단신동맥조단시간장우OPN,차이균유통계학의의(P＜ 0.05).량조주원비용비교차이무통계학의의(P＞0.05),LPN조적술후주원시간、동통지속시간、술후지통약용량、하상활동시간、장도공능회복시간、발출인류관시간균저우OPN조,차이유통계학의의(P＜0.05).술후1개월량조혈청기항、뇨소、뇨산함량적변화상당,차이무통계학의의(P＞0.05).LPN조흉/복막손상솔、신주혈종솔、절구감염솔균요우우OPN조,차이유통계학의의(P＜ 0.05).결론 LPN구유침대성강、창상소、회복쾌、병발증소적우점,가작위신장소종류적수선치료방법.
Objective To evaluate the clinical effect and safety of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) for renal tumor.Methods 49 patients with renal tumor undertaking LPN at our hospital from August,2012 to June,2014 were chosen as group LPN,and 50 undertaking OPN from the same time period group OPN.The basic situation of surgery,complications,and prognosis were compared between the two groups.Results There was no statistical difference in operation time and hospitalization fee between the two groups(P＞0.05).The average intraoperrative bleeding volume was less and the renal artery occlusion time was longer in group LPN than in group OPN,with the statistical differences(P＜0.05).The hospital stay,postoperative pain time,ambulation time,intestinal-function-recovered time,and drainage-tube-pulled-out time were shorter and postoperative analgesic drug consumption was less in group LPN than in group OPN,with statistical differences(P＜0.05).There were no statistical differences in the serum levels of creatinine,urea,and uric acid between the two groups(P＞0.05).The incidence of postoperative complications was statistically lower in group LPN than in group OPN(P＜0.05).Conclusions LPN is highly targeted and not quite traumatic,has shorter recover time,occurred fewer complications than OPN,so it can be the first choice for small renal tumor.