腹膜后肿瘤结扎左肾静脉后免重建指标的研究

The study of indicator of no-need-reconstruction left renal vein after ligation in retroperitoneal tumor patients

目的 探讨测量左肾静脉结扎前后管腔内静脉压力变化值（ΔP值）作为左肾静脉结扎后免重建的客观指标的可行性.方法 入选2014年12月至2018年1月在北京大学国际医院就诊符合入组标准的患者25例,患者均为腹膜后肿瘤侵犯下腔静脉及右侧肾脏,手术时需要切除下腔静脉＋右侧肾脏＋结扎左肾静脉.术中根据ΔP值变化来计算出左肾静脉免重建ΔP值的安全范围.结果 通过线性回归分析,对比ΔP值与尿量的相关性,ΔP值的安全值范围为0～17.5 cm H2O,在此范围的ΔP值左肾静脉可免重建.结论 ΔP值可作为术中左肾静脉免重建的客观指标,此指标安全有效,可应用于临床.

Objective We hypothesized that the change value ΔP of left renal vein pressure before and after the ligation can serve as an objective indicator of necessity of reconstruction of left renal vein, after resection of retroperitoneal tumor with renal segment of inferior vena cava and right kidney invaded. Methods 25 cases of retroperitoneal tumor with invasion of inferior vena cava and right kidney were collected, excision of inferior vena cava, right kidney and ligation of left renal vein were imperative. ΔPs of left renal vein before and after the ligation were measured. Reconstruction-free range of ΔP variation was calculated using regression analysis. Results The reconstruction-free range of ΔP before and after ligation of the left renal vein was verified by diuretic response test. The safety range of ΔP is 0-17.5 cm H2O. Conclusion ΔP is capable of indicating whether reconstruction of left renal vein or not, after resection of retroperitoneal tumor with renal segment of the inferior vena cava and right kidney.