经腹腹腔镜联合带蒂大网膜包裹治疗特发性肾包膜下积血

Transabdominal laparoscopy combined with pedicled great omentum wrapping for the treatment of spontaneous subcapsular renal hematoma

目的对比研究带蒂大网膜包裹对特发性肾包膜下积血的疗效。方法19例特发性肾包膜下积血的患者随机分为两组，均由同一手术组医师进行手术，A组9例，行经腹腹腔镜肾包膜下积血清除术，B组10例，行经腹腹腔镜肾包膜下积血清除＋大网膜包裹引流术。记录两组患者手术时间、术中出血量、术后。肾周引流量、肾周引流管留置时间、住院时间及半年复发率等指标并进行对比。结果两组术中出血量比较差异无统计学意义（P〉0．05）；手术时间A组短于B组，差异有统计学意义（P〈0．05）；肾周引流量、引流管留置时间、住院时间A组明显高于B组，差异有统计学意义（P〈0．01）。半年复发率A组高于B组，差异有统计学意义（P〈0．05）。结论联合带蒂大网膜包裹治疗特发性肾包膜下血肿较单一经腹腹腔镜血肿清除术更有效。

Objective To analyze the effects of transabdominal laparoscopy combined with pedi- cled great omentum wrapping for spontaneous subcapsular renal hematoma. Methods Nineteen spontane- ous subcapsular renal hematoma patients were randomly divided into two groups and operated by the same group of surgeons, Nine patients in group A underwent transabdominal laparoscopy to eliminate hematoma, and other 10 patients in group B underwent the same procedure combined with pedicled great omentum wrapping. Operation time, intraoperative blood loss, perinephrium drainage, postoperative drainage time, hospital stay and recurrence rate in six months were recorded and compared. Results There was no signif- icant difference in intraoperative blood loss between the two groups. The operation time in group B was a little longer than that in group A（ P 〈 0.05 ）, but perinephrium drainage, postoperative drainage time, and hospital stay were lower than those in group A（ P 〈 0.01 ）. The recurrence rate in 6 months in group A was higher than that in group B （P 〉 0.05 ）. Conclusion Transabdominal laparoscopy combined with pedicled great omentum wrapping is more effective for the treatment of spontaneous subcapsular renal hematoma.