后腹腔镜保留肾单位手术治疗早期肾癌患者的术肾肾功能分析

Analysis of the Posterior Laparoscope Nephron Sparing Surgery to the Diseased Kidney Renal Function

目的：探讨后腹腔镜保留肾单位手术（LNSS）对早期肾癌患者术后术肾肾功能的影响。方法：收集并随访新疆维吾尔自治区人民医院泌尿外科2009年1月~2012年6月接受经后腹膜行腹腔镜保留肾单位术治疗,且术后病检结果为肾癌患者的临床资料,分别于术前、术后24小时、2周、6月、1年、1.5年、2年测定双肾GFR、血清肌酐、血清胱抑素指标值,随访时间大于2年的有28例患者,比较并分析各指标值的变化情况,分析LNSS术对肾功能的影响。结果：28例患者术肾术前GFR及占总GFR的比例分别为42.02±7.31 ml/min和43.30±3.6%,术后2周分别为31.42±5.23 ml/min和34.83±5.8%,术后6月分别为33.23±5.46ml/min和36.85±5.3%,术后1年分别为37.21±6.59 ml/min和39.74±6.2%,术后1.5年分别为40.44±5.82 ml/min和42.26±6.2%,术后2年分别为40.64±5.74 ml/min和42.26±5.8%。术后24小时,血清肌酐水平升高,术后6个月以后与术前比较无明显差别。术后2周,血清胱抑素水平升高,术后6个月恢复到术前水平。结论：LNSS术式对早期肾癌是安全有效的。

Objective： To discuss the effects of LNSS on the functions of renal. Methods： The clinical data of patients with kidney cancer who were taken the retroperitoneum laparoscopic retention in our hospital from January 2009 to June 2009 were collected and the postoperative situations and renal functions of patients after the surgery for 24 hours, 2 weeks, 6 months, one year, one and a half year and two years in the follow-ups were observed and analyzed. Results： GFR and total GFR in 28 patients with surgical nephrectomy rates were 42.02±7.31 ml / min and 43.30±3.6%, after two weeks of GFR and total GFR ratio was 31.42±5.23 ml / min and 34.83±5.8%, after 6 months of GFR and total GFR rates were 33.23±5.46 ml / min and 36.85±5.3%, the proportion of 1 year after GFR and total GFR were 37.21±6.59 ml / min and 39.74±6.2%, after 1.5 years of GFR and total GFR ratio was 40.44±5.82 ml / min and 42.26±6.2% after 2 years GFR and total GFR ratio was 40.64 ±5.74 ml / min and 42.26±5.8%. Serum creatinine within 24 hours after increased after 6 months after surgery with no significant difference in the preoperative. The serum cystatin postoperative 2 weeks after emergence increased, to return to preoperative levels within 6 months after surgery. Conclusion： LNSS surgical of early renal tumors is safe and effective.