腹腔镜下保留肾单位肾肿瘤切除术的疗效及对患者生存质量的影响

Efficacy of Laparoscopic Nephron-sparing Resection for Renal Tumor and Its Effect on Quality of Life

目的探讨腹腔镜下保留肾单位肾肿瘤切除术的临床效果和对患者生存质量的影响。方法将86例肾细胞癌患者作为研究对象,根据患者手术方式的不同分为研究组45例,对照组41例,其中研究组患者选择腹腔镜下保留肾单位肾肿瘤切除术,对照组患者行腹腔镜根治性肾切除术,观察两组患者的手术疗效以及生存质量评分。结果研究组手术时间、术中出血量和住院时间明显多与对照组(P<0.05),差异具有统计学意义,两组患者术后引流量比较差异不显著(P>0.05),手术前两组患者手术前后血红蛋白水平比较差异不显著(P>0.05),术前尿肌酐水平比较差异不大,术后研究组患者尿肌酐水平明显高于对照组(P<0.05),差异具有统计学意义,术前两组患者生存质量评分比较差异不显著(P>0.05),随访6个月两组患者评分均明显降低,但是术后研究组患者评分明显高于对照组(P<0.05),术后随访两组患者复发率均为0,生存率分别为97.78%和95.12%,组间比较差异不显著(P>0.05)。结论腹腔镜下保留肾单位肿瘤切除术治疗肾癌患者对健侧肾功能造成的影响比较轻,同时提高患者术后生存质量,效果显著,可推广使用。

Objective To investigate the clinical effect of laparoscopic nephron-sparing resection for renal tumor and its influence on quality of life.Methods 86 patients with renal tumor were selected as the research object,according to different surgical methods,they were divided into the study group with 45 cases,and the control group with 41 cases,the study group received laparoscopic nephron-sparing resection,the control group underwent laparoscopic radical nephrectomy,observed the curative effect of the 2 groups of patients and quality of life scores.Results Operative time,bleeding volume and hospitalization time in the study group were significantly longer than those of the control group,the difference was statistically significant（P 0.05）.There had no significant difference in postoperative drainage between the 2 groups（P 0.05）,preoperative hemoglobin level of the 2 groups of patients before and after surgery had no significant difference（P 0.05）,preoperative urinary creatinine level had no significant difference,postoperative urinary creatinine levels in patients of the study group was significantly higher than the control group（P 0.05）,the difference was statistically significant.There had no significant difference in quality of life score between the 2 groups（P 0.05）,followed up for 6 months,quality of life score of the 2 groups significantly reduced.But the postoperative patients in the study group were significantly higher than those of the control group（P 0.05）,postoperative recurrence rates of the 2 groups were both 0%.The survival rates were 97.78% and 95.12%,the difference between the 2 groups was not significant（P 0.05）.Conclusion Laparoscopic nephron-sparing resection for renal tumor has less influence on the contralateral renal function,and can improve the postoperative quality of life.The effect is significant and can be popularized.