肾部分切除术与根治性肾切除术对T1b期肾癌的治疗效果比较

发布时间：2018-06-18 02:32

本文选题：局限性肾癌 + 保留肾单位手术　；参考：《河北联合大学》2014年硕士论文

【摘要】：目的通过比较肾部分切除术（partial nephrectomy, PN）与根治性肾切除术（radical nephrectomy, RN）治疗T1b期肾癌的临床效果差异，来研究PN治疗T1b期肾癌的优越性与局限性。方法回顾性分析武警后勤学院附属医院及其技术协作医院2008年1月至2012年12月期间接受手术治疗的T1b期肾癌病例92例，其中43例行PN治疗，我们作为实验组，49例行RN治疗，将其作为对照组。最后我们统计两组的术中出血量、手术时间、术后住院时间、并发症、复发率、生存率、术后1周及1月肌酐值，，并对它们进行比较及流行病学分析。结果手术时间、术中出血量、并发症发生率实验组大于对照组有统计学差异(P0.05)；而术后一周肌酐值低于对照组有统计学差异(P 0.05)；术后住院时间、肿瘤复发率及长期生存率、术后1月血肌酐值这些比较因素中两组并无统计学差异（P㧐0.05）。结论1在手术时间、术中出血量、术中及术后并发症的发生率这些方面中，PN要高于RN(P 0.05)。在住院时间、肿瘤复发率及术后长期存活率方面两者未见明显差异(P0.05)，而对于术后患者的肾功能，行RN的患者术后1周的血肌酐值要高于PN(P 0.05)，但随着时间的推移，两组未见明显差异。(P0.05)。2PN可对患者肾单位尽可能的保留，可有效增强肾脏的代偿能力，但对手术技巧要求过高，学习周期较长。相信随着医学技术不断发展，PN可成为治疗局限性肾癌的首选术式。
[Abstract]:Objective to compare the clinical effects of partial nephrectomy (PNs) and radical nephrectomy (RNs) in the treatment of stage T 1b renal cell carcinoma and to study the advantages and limitations of PN in the treatment of stage T 1b renal carcinoma. Methods from January 2008 to December 2012, 92 patients with stage T1b renal cell carcinoma received surgical treatment in the affiliated Hospital of Armed Police Logistics College and its Technical Cooperation Hospital. 43 cases were treated with PN, and 49 cases were treated with RN as experimental group. They were used as control group. Finally, we counted the intraoperative bleeding volume, operative time, postoperative hospitalization time, complications, recurrence rate, survival rate, creatinine value at 1 week and 1 month after operation, and compared them and analyzed their epidemiology. Results the time of operation, the amount of intraoperative bleeding and the incidence of complications in the experimental group were significantly higher than those in the control group (P 0.05), but the creatinine value in the first week after operation was lower than that in the control group (P 0.05), and the postoperative hospitalization time, tumor recurrence rate and long-term survival rate were significantly lower than those in the control group. There was no significant difference in serum creatinine levels between the two groups at 1 month postoperatively (P 0.05). Conclusion (1) PN was higher than RNN P 0.05 in terms of operation time, intraoperative bleeding volume, and incidence of intraoperative and postoperative complications. There was no significant difference in hospitalization time, tumor recurrence rate and postoperative long-term survival rate between the two groups. However, the serum creatinine level of patients with RN was higher than that of PNN P0.05 at 1 week after RN, but with the passage of time, there was no significant difference between the two groups. There was no significant difference between the two groups. P0.05U. 2PN could preserve the renal units as much as possible and enhance the compensatory ability of the kidney effectively. However, the requirement of surgical skills was too high and the learning period was longer. It is believed that PN may be the first choice in the treatment of localized renal cell carcinoma with the development of medical technology.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11

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