青海地区后腹腔镜与开放手术行肾上腺肿瘤对比性研究

发布时间：2018-03-24 15:41

本文选题：肾上腺肿瘤　切入点：后腹腔镜手术　出处：《青海大学》2014年硕士论文

【摘要】：目的：分析手术切除肾上腺肿瘤的两种不同方式，即后腹腔镜技术、开放手术技术，评价两种方式各自的临床价值。目的在于评价两者在治疗肾上腺肿瘤方面的疗效及其安全性。研究对象和方法：收集2012年5月-2014年3月于青海省人民医院泌尿外科诊治的肾上腺肿瘤患者40例；其中，行后腹腔镜手术治疗的20例（A组），行开放手术治疗的20例（B组）。总结、统计、分析以上两种术式（A组、B组）的手术时间、手术出血量、手术住院时间以及手术前后患者pH值、PCO-2、HCO3、BE等相关指标。结果：两组手术时间分别为(74.50±8.76) min和(131.90±13.20) min；术中出血量分别为(67.25±33.89)ml和(126.50±48.34)ml；术后住院天数分别为(5.55±1.54)天和(10.45±2.11)天；术前两组pH(7.42±0.25)和(7.41±0.25)、PCO2(36.65±2.11)mmHg和(37.00±2.02)mmHg、HCO-3(25.11±1.50)mmol/l和（24.72±1.16）mmol/l、 BE(1.21±1.67)mmol/l和(1.15±1.56)mmol/l；术后即刻两组pH(7.35±0.19)和(7.40±0.32)、PCO2(42.20±2.61)mmHg和(38.25±2.63)mmHg、HCO-3(23.13±1.16)mmol/l和（23.97±1.40）mmol/l、 BE(-0.97±1.43)mmol/l和(0.42±1.56)mmol/l。结论：1.后腹腔镜肾上腺肿瘤切除术在手术时间、术中出血量、术后住院天数等方面数据与开放手术相关项目比较具有明显优势(PO．01)。 2.后腹腔镜肾上腺肿瘤切除手术对患者血气有一定的影响，应加强围手术期监测和管理，使血气变化维持在正常范围，，以减轻或减少术中并发症。
[Abstract]:Objective: to analyze two different methods of resection of adrenal tumors, that is, retroperitoneal laparoscopy and open surgery. Objective to evaluate the efficacy and safety of the two methods in the treatment of adrenal tumors. Subjects and methods: from May 2012 to March 2014, 40 patients with adrenal neoplasms diagnosed and treated in urology department of Qinghai Provincial people's Hospital were collected. Twenty cases of group A were treated by retroperitoneal laparoscopy, and 20 cases of group B were treated with open surgery. The time of hospitalization and the pH value of PCO-2HCO3BE were measured before and after operation. Results: the operative time was 74.50 卤8.76 min and 131.90 卤13.20 min, the intraoperative bleeding was 67.25 卤33.89)ml and 126.50 卤48.34 ml, the postoperative hospitalization days were 5.55 卤1.54 days and 10.45 卤2.11 days, respectively; the preoperative pH(7.42 卤0.25) and 7.41 卤0.25PCO2C36.65 卤2.11)mmHg and 37.00 卤2.02mHgHCO-325.11 卤1.50)mmol/l and 24.72 卤1.16mmolll, BE(1.21 卤1.67)mmol/l and 1.15 卤1.56mmol / l of BE(-0.97, respectively; immediately after operation, the two groups were pH(7.35 卤190.and 7.40 卤0.32P2CO42.20 卤2.61)mmHg and 38.63H2H-1 卤36.13 卤1.43)mmol/l 卤1.40mmol-1, respectively. Conclusion retroperitoneal laparoscopic adrenalectomy has significant advantages over open surgery in terms of operation time, intraoperative bleeding volume and postoperative hospital stay. 2. Retroperitoneal laparoscopic adrenalectomy has a certain effect on blood gas in patients. The perioperative monitoring and management should be strengthened to keep the change of blood gas in normal range, in order to reduce or reduce the complications during operation.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699

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