小肾癌行NSS术后肾功能的评价

Effect of Nephron Sparing Surgery on Postoperative Renal Function

目的研究小肾癌行选择性保留肾单位手术(NSS)对术后肾功能的影响。方法回顾性分析83例肿瘤直径≤4cm的肾细胞癌患者手术治疗的效果,其中NSS患者44例,根治性肾切除术(RN)39例,观察两组患者术后肾功能变化。结果 NSS组患者术后1个月各项指标与RN组患者相比差异有统计学意义(P<0.05),术后3个月、12个月两组各项指标比较无统计学意义(P>0.05)。术前、术后3个月及12个月GFR水平均明显高于术后1个月的水平,差异均有统计学意义(P<0.01)。结论小肾癌行NSS能最大程度上保留肾单位的功能,降低术后肾功能衰竭的发生,值得临床推广应用。

Objective To study the effect of nephron sparing surgery on postoperative renal function. Methods 83 cases of small renal carcinoma operation with tumor diameter ≤4 cm were analyzed retrospectively, with NSS operation of 44 cases, RN of 39 cases. The changes of postoperative renal function of two groups were observed. Results The difference of indices after one month of treatment between NSS group and RN group was statistically significant （P 〈0.05）, while the differences after 3 and 12 months of treatment were not statistically significant （P 〉0.05）. The GFR levels before the operation, 3 and 12 months after the operation were statistically higher than those one month after the operation （P 〈0.01）. Conclusions Nephron sparing surgery in the treatment of small renal carcinoma can retain the function of nephron maximally, reduce the incidence of postoperative renal failure, which is worthy of clinical application.