两种不同肾部分切除术治疗复杂性肾肿瘤患者的效果对比

Comparison of the Effects of Two Different Partial Nephrectomy on Patients with Complicated Renal Tumors/

目的:探究腹腔镜肾部分切除术和开放肾部分切除术在复杂性肾肿瘤中应用效果和安全性。方法:选择2017年1月-2019年12月于本院泌尿外科住院治疗的复杂性肾肿瘤患者60例,利用随机数字表法将其分为研究组(30例)和对照组(30例)。对照组采用开放肾部分切除术,研究组采用腹腔镜肾部分切除术。比较两组手术时间、术中出血量、肾动脉阻断时间、引流时间、开始进食时间、肠道恢复时间、住院天数、肾功能指标以及术后并发症发生情况。结果:研究组术中出血量少于对照组(P<0.05),两组的肾动脉阻断时间和手术时间比较,差异均无统计学意义(P>0.05)。研究组引流时间、开始进食时间、肠道恢复时间、住院天数均短于对照组(P<0.05),研究组术后2、8、12 h的VAS评分均低于对照组(P<0.05),同时研究组镇痛药物用量少于对照组(P<0.05)。研究组术后的Scr、Cys C、β2-MG水平均低于对照组(P<0.05)。研究组并发症发生率为10.00%,对照组为6.67%,两组比较差异无统计学意义(P>0.05)。结论:与开放肾部分切除术相比,腹腔镜肾部分切除术能够缩短引流时间和胃肠功能恢复时间,改善术后疼痛和肾功能下降,且不增加并发症。

Objective:To investigate the effect and safety of laparoscopic partial nephrectomy and open partial nephrectomy in complex renal tumors.Method:A total of sixty patients with complex renal tumors hospitalized in the department of urology from January 2017 to December 2019 were selected.They were divided into study group(n=30)and control group(n=30)by random number table method.The control group used partial open nephrectomy,and the study group used laparoscopic partial nephrectomy.The operation time,intraoperative blood loss,renal artery occlusion time,drainage time,food intake time,intestinal recovery time,length of hospital stay,renal function index and postoperative complications were compared between the two groups.Result:The intraoperative blood loss in the study group was less than that in the control group(P<0.05),and there was no statistical differences in the renal artery occlusion time and the operation time between the two groups(P>0.05).The drainage time,food intake time,intestinal recovery time,and length of hospital stay in the study group were shorter than those in the control group(P<0.05),VAS scores at 2,8 and 12 h after surgery in the study group were all lower than those in the control group(P<0.05),at the same time,the amount of analgesic drugs in the study group was less than that in the control group(P<0.05).The postoperative Scr,Cys C,andβ2-MG levels of the study group were all lower than those of the control group(P<0.05).The incidence of complications was 10.00%in the study group and 6.67%in the control group,the difference between the two groups was not statistically significant(P>0.05).Conclusion:Compared with open partial nephrectomy,laparoscopic partial nephrectomy can shorten the drainage time and the recovery time of gastrointestinal function,improve postoperative pain and decline in renal function without increasing complications.