CT肾血管成像在后腹腔镜肾部分切除术中的应用

发布时间：2018-04-08 16:36

本文选题：CT血管成像　切入点：后腹腔镜　出处：《重庆医科大学学报》2015年01期

【摘要】：目的:探讨肾CT血管成像(computed tomography angiography,CTA)在后腹腔镜肾部分切除术中的临床意义。方法:本研究选择需要行后腹腔镜肾部分切除患者40例,随机分为2组,20例术前行肾血管CTA,20例仅作一般增强CT。了解肾动脉变异情况,比较2组患者手术时间、热缺血时间、术中出血量、术后住院时间、术后肾小球滤过率(glomerular filtration rate,GFR)降低值、并发症发生率。结果:CTA组术前发现肾动脉分布情况与术中解剖情况一致。CTA组1例改行腹腔镜根治性肾切除术,对照组2例改行开放根治性肾切除术。CTA组中有7例在术中选择性阻断肾动脉。2组均无明显并发症发生;2组术后病检均未见切缘阳性。CTA组和对照组热缺血时间分别为(27.4±6.2)min和(29.2±5.1)min,差异无统计学意义(t=1.00,P=0.322);CTA组术中出血量、术后住院时间、术后GFR降低值分别为(33.3±11.0)ml、(4.2±0.8)d、(6.1±2.1)ml/min明显低于对照组,差异有统计学意义(t=4.04、P=0.001,t=2.85、P=0.007,t=3.06、P=0.004)。结论:CTA能为后腹腔镜下肾部分切除术提供有效指导,可以成为术前常规检查。
[Abstract]:Objective: to investigate the clinical significance of computed tomography angiography in retroperitoneal laparoscopic partial nephrectomy.Methods: in this study, 40 patients who needed retroperitoneal laparoscopic partial nephrectomy were randomly divided into two groups: 20 patients received renal vascular CTAA before operation and 20 patients received general enhanced CTs.To find out the variation of renal artery, compare the operation time, hot ischemia time, intraoperative bleeding amount, postoperative hospitalization time, glomerular filtration rate and glomerular filtration rate (GFR) decrease, and the incidence of complications in the two groups.Results the distribution of renal artery was the same as that of intraoperative anatomy in the group of 10: CTA. One case in group CTA was treated with laparoscopic radical nephrectomy.Two patients in the control group were treated with open radical nephrectomy. CTA group (7 cases) had no obvious complications during selective renal artery occlusion. CTA group and control group had no positive margin after operation. CTA group and control group had no time of hot ischemia.There was no significant difference in intraoperative blood loss between the two groups (27.4 卤6.2)min and 29.2 卤5.1 min).Conclusion 1: CTA can provide effective guidance for retroperitoneal laparoscopic partial nephrectomy and can be used as routine examination before operation.
【作者单位】：重庆三峡中心医院泌尿外科;
【基金】：重庆市卫生局医学科研资助项目(编号:2013-2-171)
【分类号】：R699.2

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