腹腔镜下肾部分切除术肾动脉分支阻断术前评估:C.L.A.M.P.评分系统

发布时间：2018-06-15 17:42

本文选题：腹腔镜 + 肾部分切除术　；参考：《南京医科大学学报(自然科学版)》2017年11期

【摘要】：目的:本研究提出1个标准化的评分系统来评价肿瘤营养血管的解剖特征,并评价该评分系统对于腹腔镜下肾部分切除术中肾动脉分支阻断(segmental renal artery clamping,SRAC)术前评估的效果。方法:该评分系统包括5个参数。每个分数的权重(coefficient,C),肿瘤营养靶血管的阻断位置以及靶血管进入肾窦的位置(location,L),包括前半部分(anterior boundary,A)、跨区域(multi-boundary,M)以及后半部分(posterior boundary,P)。综合每个首字母组成本评分系统C.L.A.M.P.评分系统。回顾性研究106例接受SRAC患者的临床资料,并根据C.L.A.M.P.不同分值将患者分成低难度、中难度、高难度3组。结果:各组转至肾动脉主干阻断的比例以及阻断成功率差异均有统计学意义。然而术中失血、热缺血时间以及术后住院时间差异无统计学意义。结论:C.L.A.M.P.评分系统能够区别不同难度的SRAC,并且在识别适合行SRAC的患者方面有良好的预测能力。
[Abstract]:Objective: to evaluate the anatomical characteristics of tumor nutrient vessels by a standardized scoring system, and to evaluate the effect of this scoring system on the preoperative evaluation of segmental renal artery clamping during laparoscopic partial nephrectomy. Methods: the scoring system included 5 parameters. The weights of each fraction were as follows: (1) the blocking position of the nutritional target vessel and the location of the target vessel entering the renal sinus, including the anterior half of the anterior inbound Agna, the cross-regional multi-boundaryMe, and the posterior part of the tumor, and the location of the target vessel entering the renal sinus. This scoring system, C.L.A.M.P., consists of a combination of each acronym. Scoring system. The clinical data of 106 patients receiving SRAC were retrospectively studied. Patients were divided into 3 groups with different scores: low difficulty, middle difficulty and high difficulty. Results: there were statistically significant differences in the proportion and success rate of transposition to the main renal artery in each group. However, there was no significant difference in intraoperative blood loss, hot ischemia time and postoperative hospitalization time. Conclusion: C.C.L.A.M.P. The scoring system can distinguish between different levels of SRAC and has good predictive ability in identifying patients suitable for SRAC.
【作者单位】：南京医科大学第一附属医院泌尿外科;阜阳职业技术学院;南京医科大学第一临床医学院;灌云县人民医院影像科;
【基金】：国家自然科学基金(81672531)
【分类号】：R737.11

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