后腹腔镜和经腹腹腔镜下肾上腺肿瘤切除的临床效果对比

Comparison of Clinical Effects of Retrolaparoscopy and Transabdominal Laparoscopic Adrenal Tumor Resection

目的:探究后腹腔镜和经腹腹腔镜下肾上腺肿瘤切除术的临床效果。方法:选择2021年1月—2023年1月济宁市第一人民医院收治的肾上腺肿瘤患者80例,以随机数字表法分为两组,对照组(经腹腹腔镜下肾上腺肿瘤切除术)及观察组(后腹腔镜下肾上腺肿瘤切除术),各40例。对比两组临床指标(手术时间、术中出血量、引流量、胃肠功能恢复时间、住院时间)、肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、尿红细胞(RBC)]、炎症因子[白细胞(WBC)、C反应蛋白(CRP)]及超氧化物歧化酶(SOD)。结果:观察组手术时间、住院时间、胃肠功能恢复时间均较对照组更短,术中出血量、引流量均较对照组更少,差异均有统计学意义(P<0.05)。术前,两组Scr、BUN、尿RBC对比,差异均无统计学意义(P>0.05);术后,两组Scr、BUN均下降,尿RBC均升高,观察组尿RBC低于对照组,差异均有统计学意义(P<0.05);术后,两组Scr、BUN对比,差异均无统计学意义(P>0.05)。术前,两组WBC、CRP、SOD对比,差异均无统计学意义(P>0.05);术后,两组WBC、CRP、SOD均升高,观察组CRP低于对照组,SOD高于对照组,差异均有统计学意义(P<0.05);术后,两组WBC水平对比,差异无统计学意义(P>0.05)。结论:与经腹腹腔镜下肾上腺肿瘤切除术相比,后腹腔镜下肾上腺肿瘤切除术更具优势,其手术时间更短,术中出血量更少,可促进患者康复,对患者肾功能影响较小。

Objective:To investigate the clinical effects of retrolaparoscopy and transabdominal laparoscopic adrenal tumor resection.Method:A total of 80 patients with adrenal tumor admitted to Jining NO.1 People's Hospital from January 2021 to January 2023 were selected and divided into two groups according to random number table method,the control group(transabdominal laparoscopic adrenal tumor resection)and the observation group(retroperitoneal laparoscopic adrenal tumor resection),with 40 cases in each group.Clinical indexes(operation time,intraoperative bleeding volume,drainage volume,gastrointestinal function recovery time,hospital stay),renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),urine red blood cell(RBC)],inflammatory factors[white blood cell(WBC),C reactive protein(CRP)]and superoxide dismutase(SOD)were compared between the two groups.Result:The operation time,hospital stay and gastrointestinal function recovery time in the observation group were shorter than those in the control group,and the intraoperative bleeding volume and drainage volume were less than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in Scr,BUN and urine RBC between two groups(P>0.05).After operation,Scr and BUN decreased and urine RBC increased in both groups,and urine RBC in observation group was lower than that in control group,the differences were statistically significant(P<0.05).After operation,there were no significant differences in Scr and BUN between the two groups(P>0.05).Before operation,there were no significant differences in WBC,CRP and SOD between the two groups(P>0.05).After operation,WBC,CRP and SOD were increased in both groups,CRP in observation group was lower than that in control group,SOD in observation group was higher than that in control group,the differences were statistically significant(P<0.05).After operation,there was no significant difference in WBC level between the two groups(P>0.05).Conclusion:Compared with transabdominal laparoscopic adrenal tumor resection,retrolaparoscopy adrenal tumor resection has more advantages,with shorter operation time and intraoperative bleeding volume,which can promote patients'recovery and have less impact on patients'renal function.