腹腔镜与开放性肾部分切除术治疗恶性肾脏肿瘤的效果及对肾功能的影响

Efficacy of Laparoscopic and Open Partial Nephrectomy for Malignant Kidney Tumor and Its Effect on Renal Function

目的探究腹腔镜肾部分切除术和开放性肾部分切除术治疗恶性肾脏肿瘤的疗效及其对肾功能的影响。方法选择80例进行肾部分切除术的恶性肾脏肿瘤患者为研究对象,进行腹腔镜肾部分切除术(LPN)患者有42例(LPN组),进行开放性肾部分切除术(OPN)的患者有38例(OPN组)。比较2组患者术中和术后的情况,检测2组患者术前1天和术后1周肾功能指标[血清胱抑素C(CysC)、尿素(UREA)、血清肌酐(Cr)、尿酸(UA)、血β2-微球蛋白(β2-MG)]。结果 LPN组术中出血量、热缺血时间、术后至开始进食时间、术后肠道恢复时间、术后引流时间、术后输血例数、术后止痛药使用量、术后住院天数和住院费用、并发症发生率、Cysc、Cr和β2-MG水平均低于OPN组,差异均具有统计学意义(P<0.05)。2组的手术时间和UREA差异无统计学意义(P>0.05)。结论腹腔镜肾部分切除术治疗恶性肾脏肿瘤的疗效优于开放性肾部分切除术,具有恢复快和创伤小等优点,且有利于肾功能水平的改善。

Objective To explore the efficacy of laparoscopic partial nephrectomy and open partial resection for malig -nant renal tumors ,and its impact on renal function .Methods 80 patients with malignant renal tumors received partial nephrecto-my were selected,42 cases received laparoscopic partial nephrectomy （LPN group）,38 patients received open partial nephrectomy （OPN group）,the situation were compared between the 2 groups during and after surgery ,and intraoperative detection of the first 2 groups of patients 1 day and 1 week after renal function [serum cystatin C （CysC）,urea （uREA）,serum creatinine （Cr）,uric acid （UA）,blood β2-microglobulin （β2-MG）].Results Blood loss,warm ischemia time to start eating after surgery ,postopera-tive intestinal recovery time ,postoperative drainage time ,the number of cases after blood transfusion ,after postoperative pain med-ication use,postoperative hospital stay and hospital costs ,morbidity,Cysc,Cr andβ2-MG levels of the LPN group were lower than those of the OPN group,the differences were statistically significant （P〈0.05）.Operative time and UREA of the 2 groups had no significant difference（P〉0.05）.Conclusion Efficacy of laparoscopic partial nephrectomy for malignant renal tumors are supe -rior to open partial nephrectomy ,with less trauma and faster recovery ,and help to improve the level of renal function .