后腹腔镜下与开放式聚丙烯网带肾固定术的疗效评价

Curative effect evaluation of retroperitoneal laparoscopic and open polypropylene mesh belt nephropexy

目的 对比分析开放式与后腹腔镜下聚丙烯网带肾固定术在肾下垂临床治疗中的应用效果.方法 选择2008年4月至2017年12月本院收治的肾下垂患者64例,按照术式分为对照组和观察组两组实施对比研究,每组32例,对照组给予开放式的聚丙烯网带经12肋肾脏悬吊术,观察组给予后腹腔镜下聚丙烯网带肾固定术治疗.观察两组患者的有效率（复发率、并发症）、手术时间、出血量、术后镇痛、卧床时间、住院时间、生活质量等实验数据.结果 观察组患者的平均手术时间、卧床时间、住院时间均显著短于对照组,出血量显著少于对照组,术后镇痛人数显著少于对照组（P＜0.05）.观察组患者的术后并发症发生率显著低于对照组（P＜0.05）.经36个月的随访,对照组、观察组均无一例出现复发,复发率为0％（P＞0.05）.经不同的治疗之后,两组患者的生活质量均得到明显改善,各项指标评分均明显提高,且观察组患的治疗后生活质量更好（P＜0.05）.结论 与开放式聚丙烯经12肋肾脏悬吊术治疗进行比较,对后腹腔镜下聚丙烯网带肾固定术疗效显著,可以获得满意的临床疗效.

Objective To compare effect of retroperitoneal laparoscopic and open polypropylene mesh belt nephropexy in the treatment of nephroptosis.Methods Between April 2008 and December 2017,64 patients with renal prolapse in our hospital were divided into control group and observation group according to surgical method,32 cases in each group.The patients in the control group underwent open polypropylene mesh belt after 12 ribs kidney suspension,the observation group was given laparoscopic polypropylene mesh belt nephropexy treatment.Recurrence rate,complication,operation time,blood loss,postoperative analgesia,bed time,length of hospital stay,the quality of life of two groups were observed.Results The average operation time,bed time,length of hospital stay of the observation group were significantly shorter than the control group,blood loss was significantly less than the control group,the number of postoperative analgesia was significantly less than the control group （P ＜ 0.05）.Postoperative complication rate of observation group was significantly lower than control group （P ＜ 0.05）.No recurrence between the two groups was found,and the recurrence rate was 0％ at 36-months follow-up （P ＞ 0.05）.After different treatment,Two groups got significant improvement in the patient＇s quality of life,each index score was significantly improved,and the observation group had better quality of life after treatment （P ＜ 0.05）.Conclusions Compared with the open polypropylene by 12 ribs for the treatment of kidney suspension,the curative effect of retroperitoneal？ laparoscopic polypropylene mesh belt nephropexy is better.