OPN与LPN手术方法治疗肾肿瘤临床疗效及安全性对比研究

Clinical efficacy and safety of OPN versus LPN for renal tumor

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.

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.