肾部分切除术前CTA联合CTU辅助检查对肾癌患者治疗效果的影响

Therapeutic effect of CTA combined with CTU before partial nephrectomy in patients with renal carcinoma

目的研究肾部分切除术术前应用计算机体层摄影血管造影(CTA)联合计算机体层摄影尿路造影(CTU)检查,对手术治疗的效果影响。方法回顾性分析接受肾部分切除术的102例肾癌患者的临床资料。将接受CTA联合CTU检查的患者作为观察组(n=48),未接受其中任一项检查的患者作为对照组(n=54)。比较两组患者手术时间、术中热缺血时间、术中出血量、术后卧床时间、拔管时间、住院时间,以及两组患者手术前后肾小球滤过率(GFR)变化情况。结果观察组患者手术时间、术中热缺血时间、拔管时间、住院时间均明显短于对照组患者(P﹤0.01),术中出血量和GFR变化率明显低于对照组患者(P﹤0.01)。两组患者卧床时间比较,差异无统计学意义(P﹥0.05)。观察组患者肾部分切除术术后并发症总发生率13.0%,低于对照组患者的并发症总发生率22.0%,差异有统计学意义(P﹤0.05)。结论肾癌患者肾部分切除术前接受CTA联合CTU检查,可有效减少术中手术时间,降低术中出血量。

Objective To explore the effect of computed tomography angiography(CTA)combined with computed tomography urography(CTU)before partial nephrectomy in patients with renal carcinoma.Method A retrospective study was performed on 102 patients who underwent partial nephrectomy for renal carcinoma,those who underwent CTA and CTU before surgery were included as the study group(n=48),others who were given neither CTA nor CTU were assigned as control group(n=54).For both groups,the operative time,intraoperative warm ischemia time,intraoperative blood loss,postoperative bed rest,extubation time,hospital stay and change of glomerular filtration rate(GFR)as well as other related measures before and after surgery were compared.Result The operative time,intraoperative warm ischemia time,intraoperative blood loss,extubation time,and hospital stay were significantly shorter in study group than those in control group(P<0.01),besides,less intraoperative blood loss and lower change of GFR were observed in study group compared with that of control group(P<0.01).The bed rest after surgery were generally similar in both groups(P >0.05).After partial nephrectomy,the incidence rate of postoperative complications in study group was 13.0%,which was lower than that in control group at 22.0%,showing statistically significant difference(P<0.05).Conclusion CTA combined with CTU examination before partial nephrectomy can effectively reduce the operative time and the volume of intraoperative blood loss in patients with renal carcinoma.