腹腔镜肾部分切除术式与肾癌根治术式对老年肾癌(T1期)患者的疗效及康复作用比较

Comparison of curative effect and rehabilitation effect of laparoscopic partial nephrectomy and radical nephrectomy on elderly patients with renal cancer(T1 stage)

目的比较腹腔镜肾部分切除术式(PN)与肾癌根治术式(RN)对老年肾癌(T1期)患者的疗效及康复作用。方法回顾分析2018年1月~2020年12月解放军总医院第三医学中心收治的肾癌(T1期)老年患者104例,以随机数表法进行分组,对照组(n=52),行腹腔镜RN,研究组(n=52),行腹腔镜PN,对两组患者的手术情况与术后康复情况。结果研究组手术时间低于对照组,拔管时间、住院时间高于对照组,差异有统计学意义(t=4.558、4.149、2.683,P<0.05);2组术中出血量、术后进食时间对比无明显差异(P>0.05);研究组手术后肾小球滤过率(GFR)高于对照组,而肌酐(Cr)、血尿素氮(BUN)低于对照组,差异有统计学意义(t=3.383、5.451、2.248,P<0.05);研究组术后并发症发生率高于对照组,差异有统计学意义(χ^(2)=5.282,P<0.05)。结论腹腔镜肾脏部分切除术式与肾癌根治术式用于肾癌(T1期)老年患者治疗各有优劣,PN的肾功能改善效果更优,但RN并发症更少,术后康复更快。

Objective To compare the curative effect and rehabilitation effect of laparoscopic partial nephrectomy(PN)and radical nephrectomy(RN)in elderly patients with renal cancer(T1 stage).Methods The data of 104 elderly patients with renal cancer(T1 stage)admitted to our hospital from January 2018 to December 2020 were retrospectively analyzed and grouped by random number table method.The control group(n=52)received intraperitoneal Endoscopy RN,the study group(n=52),laparoscopic PN,the operation conditions and postoperative rehabilitation of the two groups of patients.Results The operation time of the study group was lower than that of the control group,and the extubation time and hospitalization time were higher than those of the control group(t=4.558,t=4.149,t=2.683,P<0.05);intraoperative blood loss and postoperative eating time of the two groups There was no significant difference in comparison(P>0.05);the glomerular filtration rate(GFR)of the study group after surgery was higher than that of the control group,while creatinine(Cr)and blood urea nitrogen(BUN)were lower than those of the control group.The control group(t=3.383,t=5.451,t=2.248,P<0.05);the incidence of postoperative complications in the study group was higher than that in the control group(χ^(2)=5.282,P<0.05).Conclusion Laparoscopic partial nephrectomy and radical nephrectomy have their own advantages and disadvantages in the treatment of elderly patients with renal cancer(T1 stage).PN has better renal function improvement effect,but RN has fewer complications and postoperative rehabilitation.faster.