经腹膜后途径与经腹途径腹腔镜肾癌根治术对老年患者肝功能的影响

发布时间：2018-05-16 18:34

本文选题：腹腔镜肾癌根治术 + 经腹途径　；参考：《中国老年学杂志》2016年08期

【摘要】：目的前瞻性分析比较经腹膜后途径与经腹途径腹腔镜肾癌根治术后老年患者肝功能的变化及原因。方法原发性老年肾癌患者61例,无其他肿瘤及肝脏疾病病史,肾肿瘤分期T1N0M0。经腹膜后途径腹腔镜肾癌根治术31例,经腹途径腹腔镜肾癌根治术30例。肿瘤平均直径分别为(5.1±2.2),(4.8±1.7)cm。记录手术前后肝功能的变化,比较手术对两组患者肝功能的影响。结果两组患者手术过程顺利,经腹膜后途径组患者术后第1、3、7天肝功能各指标接近正常。经腹途径组患者术后第1天丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)轻度增高,术后给予保肝药物,第3天ALT、AST明显下降,第7天ALT、AST恢复正常值,γ氨基酸转肽酶(γ-GT),血清总胆红素(TBIL)未发生明显变化。结论经腹膜后途径腹腔镜肾癌根治术对肝功能影响低于经腹途径腹腔镜肾癌根治术,肠道功能恢复快,提示经腹膜后途径手术创伤程度轻,恢复快。
[Abstract]:Objective to compare the changes and causes of liver function between retroperitoneal and transabdominal laparoscopic radical renal cell carcinoma patients. Methods 61 cases of primary renal cell carcinoma with no history of other neoplasms and liver diseases, T _ 1N _ (0) M _ (0). Retroperitoneal laparoscopic radical nephrectomy was performed in 31 cases and laparoscopy in 30 cases. The mean diameter of tumor was 5.1 卤2.2 cm. The changes of liver function before and after operation were recorded and the effects of operation on liver function were compared between the two groups. Results the operation process of the two groups was smooth, and the liver function indexes of the patients in the retroperitoneal approach group were close to normal on the 1st day and 7th day after operation. In the transabdominal approach group, alanine aminotransferase (alt) and aspartate aminotransferase (AST) increased slightly on the first day after operation. On the 7th day, AST returned to normal value, but 纬 -amino acid transpeptidase (纬 -GTN), serum total bilirubin TBIL did not change significantly. Conclusion the effect of retroperitoneal laparoscopic radical nephrectomy on liver function is lower than that on abdominal laparoscopic radical renal cell carcinoma, and intestinal function recovers quickly, suggesting that retroperitoneal surgery is less traumatic and faster. [WT5HZ] [WT5 "BZ] [WT5" BZ] [WT5 "BZ] [WT5" BZ]
【作者单位】：河北北方学院附属第一医院泌尿外科;河北北方学院检验学院;张家口市沙岭子医院急诊科;
【基金】：张家口市科学技术与发展指导计划项目(1321124D) 河北北方学院青年基金项目(Q201126)
【分类号】：R737.11

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