| 钟林 王娟英 宋斌 杨帆 许志斌 罗丹 张静 付强.后腹腔镜下保留肾单位肾部分切除术后肾功能的影响因素分析[J].,2014,14(27):5264-5266 |
| 后腹腔镜下保留肾单位肾部分切除术后肾功能的影响因素分析 |
| Protection after Laparoscopic Partial Nephrectomy in Renal Units ReservedPostoperative Renal Function |
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| DOI： |
| 中文关键词: 保留肾单位 肾功能保护 后腹腔镜 |
| 英文关键词: Nephron sparing Renal protection Post laparoscopic |
| 基金项目:国家自然科学基金项目（81001141） |
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| 中文摘要: |
| 目的：分析后腹腔镜下保留肾单位肾部分切除术后患肾肾功能的影响因素。方法：回顾性分析2011 年5 月～2013 年10 月
本院收治的45 例行后腹腔镜下肾部分切除术肾癌患者的临床资料，采用99mTc-DTPA肾核素扫描评估术前及术后3 月术侧肾
的肾小球滤过率(GFR)。结果：手术时间100～240min，平均(135± 33.21)min。肾动脉阻断时间(20.01± 7.35)min，肿瘤大小(3.05±
1.24)cm。术前及术后3 月术肾GFR 分别是(46.53± 6.35)、(32.22± 4.65)ml/min。术侧肾术后GFR 下降(15.36± 2.36)ml/min，与术前
相比下降约34%。经随访1 月-2 年，无复发及转移病例，患者全部无瘤生存。影响手术前后血肌酐水平变化的相关因素主要为手
术时间、阻断时间、气流量、术中失血量(P<0.05)；影响手术前后GFR 水平变化的相关因素主要为阻断时间、气流量、手术时间
(P<0.01)。术前肾功能情况、缺血时间和肿瘤最大径是术侧肾功能下降程度的独立预测因子；术前肾功能情况和肿瘤最大径是总
体肾功能下降程度的独立预测因子。结论：后腹腔镜下保留肾单位肾部分切除术后患肾肾功能的影响因素包括术前肾功能、手术
时间、肾动脉阻断时间、气流量、术中失血量、肿瘤大小等。 |
| 英文摘要: |
| Objective:To study the influencing factors of renal function of affected side renal after retroperitoneoscopy partial
nephrectomy retaining nephron.Methods:The clinical data of 45 patients with kidney cancer who were admitted from May 2011 to
October 2013 and had taken laparoscopic partial nephrectomy were retrospectively analyzed. The kidney glomerular filtration rate (GFR)
of affected side renal before and 3 months after operation was assessed using 99mTc-DTPA renal scintigraphy.Results:The operation
time was 100~240min, on average (135± 3.21) min. Renal artery occlusion time was (20.01± 7.35) min. Tumor size was (3.05± 1.24)
cm. GFR of affected side renal before and 3 months after operation respectively were (46.53± 6.35) and (32.22± 4.65) ml/min. GFR of
affected side renal declined (15.36± 2.36) ml/min after surgery, and decreased by 34%compared with pre-operation. During a 1 month-2
years follow-up visit, all patients survived with tumor-free and there was no recurrence and metastasis. The operation time, renal artery
occlusion time, gas flow and blood loss volume intraoperative were the main influence factors of serum creatinine level before and after
operation (P<0.05). The renal artery occlusion time, gas flow and operation time were the main influence factors of GFR level before and
after operation (P<0.01). Renal function before surgery, ischemia time and tumor’s largest diameter were independent predictors of the
decline degree of total kidney function.Conclusion:The renal function before surgery, operation time, renal artery occlusion time, gas
flow, blood loss volume intraoperative and tumor size were the influencing factors of kidney function of affected side renal after
retroperitoneoscopy partial nephrectomy retaining nephron. |
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