摘要
目的探讨MAP肾周脂肪评分对肾肿瘤肾部分切除术术式选择的临床意义。方法回顾性分析宁夏医科大学总医院2011年1月至2016年12月间126例行肾部分切除术的肾肿瘤患者的病例资料;其中,行开放性手术(OPN)者68例,行腹腔镜手术(LPN)者58例;所有患者经术前腹部CT结果进行MAP评分,并分为MAP低度组(0~1分)、MAP中度组(2~3分)和MAP高度组(4~5分);分析不同术式的MAP低、中、高度组间患者手术时间、术中出血量、肾缺血时间、术后住院时间和血肌酐变化幅度等临床指标的差异。结果 MAP肾周脂肪评分系统与肾部分切除术的手术方式和术后并发症有显著相关性(P<0.05)。与行OPN患者比较,在MAP低度组中,行LPN者肾缺血时间和血肌酐变化幅度较多,术中出血量和术后住院时间较少(P<0.05);在MAP中度组中,行LPN者手术时间和肾缺血时间均较长,术中出血量和术后住院时间较少(P<0.05);在MAP高度组中,行LPN者仅手术时间较长(P<0.05)。对于行OPN的患者,MAP高度组术后住院时间长于MAP低度组(P<0.05);对于行LPN的患者,MAP高度组手术时间、术中出血量和术后住院时间均多于MAP低度组(P<0.05)。结论 MAP肾周脂肪评分系统对肾部分切除术的手术方式选择具有一定指导意义,MAP低、中度的肾肿瘤患者倾向于选择腹腔镜手术,MAP高度的肾肿瘤患者倾向于选择开放性手术。
Objective To investigate the clinical significance of MAP score in the choice of approach for partial nephrectomy. Methods A retrospective analysis was conducted on the clinical data of 126 patients with renal neoplasms undergoing partial nephrectomy, including 68 cases of open partial nephrectomy (OPN) and 58 cases of laparoseopic partial nephrectomy (LPN), in General Hospital of Ningxia Medical University from January 2011 to December 2016. The patients were divided into low - MAP group (0 - 1 ) , moderate - MAP group ( 2 -3 ) and high - MAP group (4 - 5 ) ac- cording to preoperative CT images. The operative time, estimated blood loss, ischemia time, length of hospital stay and change in creatinine among different MAP groups with different operation approaches were compared. Results The MAP score was significantly associated with the operation approach and postoperative complications (P 〈 0. 05 ). In low - MAP group, compared with OPN patients, ischemia time and change in creatinine were increased, whereas blood loss and length of stay were reduced in the LPN patients. In moderate - MAP group, compared with the OPN patients, operative time and ischemia time were increased, while blood loss and length of stay were reduced in the LPN patients. In high - MAP group, compared with the OPN patients, operative time was increased in LPN patients. Among patients with OPN, compared with low - MAP group, operative time was increased in high - MAP group. Among patients with LPN, compared with low - MAP group, operative time, estimated blood loss and length of stay were increased in high - MAP group. Conclusion MAP score can be used to choose the approach for partial nephrectomy. Renal neoplasms patients with low or moderate MAP tend to choose LPN, whereas renal neoplasms patients with high - MAP tend to choose OPN.
出处
《广东医学》
CAS
2018年第2期203-206,共4页
Guangdong Medical Journal
基金
国家自然科学基金资助项目(编号:81460148)