经腹腔入路与经腹膜后入路行腹腔镜肾上腺切除术对肾上腺肿瘤患者应激反应及肾功能的影响比较

Comparison of the Effects of Transabdominal and Retroperitoneal Laparoscopic Adrenalectomy on Stress Response and Renal Function in Patients with Adrenal Tumor

目的:比较经腹腔入路与经腹膜后入路行腹腔镜肾上腺切除术对肾上腺肿瘤(AT)患者应激反应及肾功能的影响。方法:回顾性分析2021年3月—2023年3月于九江市第一人民医院治疗的82例AT患者临床资料,依据手术入路的不同将其分为经腹腔入路腹腔镜肾上腺切除术(TLA)组(40例)与经腹膜后入路腹腔镜肾上腺切除术(RLA)组(42例)。比较两组应激反应、肾功能及并发症。结果:术后24 h两组丙二醛(MDA)均高于术前,超氧化物歧化酶(SOD)均低于术前,但RLA组MDA低于TLA组,SOD高于TLA组,差异均有统计学意义(P<0.05);术后24 h两组尿素氮(BUN)及血肌酐(Scr)水平均低于术前,差异均有统计学意义(P<0.05);术后24 h两组BUN及Scr水平、并发症总发生率比较,差异均无统计学意义(P>0.05)。结论:与TLA相比,RLA治疗AT患者能够减轻氧化应激反应程度,且不会加重肾功能的损伤,并发症发生率并未增加。

Objective:To compare the effects of transabdominal and retroperitoneal laparoscopic adrenalectomy on stress response and renal function in patients with adrenal tumor(AT).Method:Clinical data of 82 patients with AT treated in Jiujiang NO.1 People's Hospital from March 2021 to March 2023 were retrospectively analyzed.According to different surgical approaches,they were divided into the transabdominal laparoscopic adrenalectomy(TLA)group(40 cases)and retroperitoneal laparoscopic adrenalectomy(RLA)group(42 cases).Stress response,renal function and complications were compared between the two groups.Result:Malondialdehyde(MDA)and superoxide dismutase(SOD)in both groups at 24 hours after surgery were higher than those before surgery,but MDA in RLA group was lower than that in TLA group and and SOD was higher than that in TLA group,with statistical differences(P<0.05).The levels of urea nitrogen(BUN)and serum creatinine(Scr)at 24 hours after operation were lower than those before operation,with statistical differences(P<0.05).There were no significant differences in BUN and Scr levels at 24 hours after operation and the total incidence of complications between the two groups(P>0.05).Conclusion:Compared with TLA,RLA can reduce the degree of oxidative stress in AT patients,and does not aggravate the damage of renal function,and the incidence of complications does not increase.