后腹腔镜肾切除术治疗肾结核疗效观察

Clinical efficacy of retroperitoneal laparoscopic nephrectomy for renal tuberculosis

目的 比较后腹腔镜肾切除术与开放手术治疗肾结核的疗效.方法 回顾性分析2016年1月至2019年4月在陕西省第五人民医院接受治疗的100例肾结核患者的临床资料,根据手术方式不同分组,其中49例采用传统开放手术治疗者为对照组,51例采用后腹腔镜肾切除术治疗者为观察组.比较两组患者的临床治疗效果、围手术期指标及并发症发生情况.结果 治疗后,观察组患者的治疗总有效率为94.12%,明显高于对照组的73.47%,差异有统计学意义(P<0.05);观察组患者的手术时间为(82.36±7.01)min,明显长于对照组的(65.41±6.19)min,差异有统计学意义(P<0.05);但是观察组患者的术中出血量为(38.96±5.82)mL,明显少于对照组的(94.58±9.27)mL,住院时间为(6.18±1.08)d,明显短于对照组的(8.97±1.34)d,留置尿管时间为(1.98±0.39)d,明显短于对照组的(4.21±0.87)d,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为9.80%,明显低于对照组的26.53%,差异有统计学意义(P<0.05).结论 后腹腔镜肾切除术治疗肾结核患者术中出血量少、住院时间和留置尿管时间也相对较短,术后易恢复,治疗效果理想,预后良好,值得临床推广.

Objective To compare the effect of retroperitoneal laparoscopic nephrectomy and open surgery in the treatment of renal tuberculosis.Methods The clinical data of 100 patients with renal tuberculosis who were treated at Shaanxi Fifth People's Hospital from January 2016 to April 2019 were retrospectively analyzed.According to different treatment methods,the patients were divided into the control group(49 cases,treated with traditional open surgery)and the observation group(51 cases,treated with retroperitoneal laparoscopic nephrectomy).The clinical treatment effect,perioperative indicators,and complications of the two groups were compared.Results After treatment,the total effective rate of treatment in the observation group was 94.12%,which was significantly higher than 73.47%in the control group(P<0.05).The operation time in the observation group was(82.36±7.01)minutes,which was significantly longer than(65.41±6.19)min of the control group(P<0.05).However,the intraoperative blood loss of the observation group was(38.96±5.82)mL,which was significantly less than(94.58±9.27)mL of the control group,the length of hospital stay was(6.18±1.08)d,significantly shorter than(8.97±1.34)d of the control group,and the indwelling time was(1.98±0.39)d,significantly shorter than(4.21±0.87)d of the control group;the difference were all statistically significant(P<0.05).The incidence of complications in the observation group was 9.80%,which was significantly lower than 26.53%in the control group(P<0.05).Conclusion Compared with open surgery,retroperitoneal laparoscopic nephrectomy for patients with renal tuberculosis results in less intraoperative blood loss,shorter length of hospital stay and indwelling catheter time,with better recovery after surgery,significant treatment effect,and good prognosis.It is worthy of widespread application in clinical promotion.