后腹腔镜保留肾单位术后患肾功能影响因素分析
发布时间：2019-05-06 11:02
【摘要】：目的：探讨影响后腹腔镜保留肾单位术（RLNSS）术后患肾功能恢复的主要因素，并检测RLNSS术式的安全性，，为改进RLNSS手术操作提供相应的理论依据。 方法：回顾性分析南昌大学第一附属医院泌尿外科2011年10月至2013年12月间实施的54例RLNSS临床资料。术前及术后3月应用99mTc-DTPA（99m锝-二乙三胺五乙酸）单光子发射计算机断层（SPECT）肾动态显像技术测定患肾肾小球滤过率（GFR）的变化。应用t检验、方差分析和多元线性回归分析影响术后肾功能恢复的可能因素。 结果：纳入的54例肾肿瘤均顺利完成手术，无一术中中转开腹。肿瘤大小1.5-7.2cm（4.54±1.53）。手术时间35-120min（57.09±14.09）。术中热缺血时间0-42min（23.60±6.77）。术中估计出血量30-250ml（74.10±48.93）。术前及术后3月术肾GFR分别为24.20-62.32（46.50±9.62）ml/min、11.23-57.45（28.79±12.71）ml/min。术肾术后GFR下降（17.70±7.04）ml/min，较术前术肾下降38.06%。多元回归示：术前术肾GFR（p=0.048）、肿瘤直径（P=0.001）、热缺血时间（p=0.012）对肾功能影响有统计学意义。 结论：术前患肾GFR、肿瘤直径、热缺血时间是影响后腹腔镜保留肾单位术后患肾功能的关键因素。
[Abstract]:Aim: to investigate the main factors affecting the recovery of renal function after retroperitoneal laparoscopic renal sparing surgery (RLNSS) and to evaluate the safety of RLNSS procedure in order to provide theoretical basis for improving the operation of RLNSS. Methods: the clinical data of 54 patients with RLNSS from October 2011 to December 2013 in the first affiliated Hospital of Nanchang University were analyzed retrospectively. The changes of glomerular filtration rate (GFR) were measured by single photon emission computed tomography (99mTc-DTPA) single photon emission computed tomography (SPECT) before and 3 months after operation. T-test, variance analysis and multiple linear regression analysis were used to analyze the possible factors affecting the recovery of renal function after operation. Results: all 54 cases of renal tumors were successfully operated, none of them were converted to open surgery. Tumor size 1.5-7.2cm (4.54 卤1.53). The operation time was 35-120min (57.09 卤14.09). The time of warm ischemia during operation was 0-42min (23.60 卤6.77). The estimated intraoperative blood loss (30-250ml) was 74.10 卤48.93). The renal GFR was (24.20 卤62.32) ml/min,11.23-57.45 (46.50 卤9.62) ml/min,11.23-57.45 (28.79 卤12.71) ml/min. before and 3 months after operation. The decrease of GFR after operation was (17.70 卤7.04) ml/min, which was 38.06% lower than that before operation. Multiple regression analysis showed that the renal function was significantly affected by pre-operative renal GFR (p < 0. 048), tumor diameter (P < 0. 001) and warm ischemia time (p < 0. 012). Conclusion: the diameter of renal GFR, tumor and the time of warm ischemia are the key factors affecting renal function after retroperitoneal laparoscopic nephrectomy.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11
本文编号：2470121
[Abstract]:Aim: to investigate the main factors affecting the recovery of renal function after retroperitoneal laparoscopic renal sparing surgery (RLNSS) and to evaluate the safety of RLNSS procedure in order to provide theoretical basis for improving the operation of RLNSS. Methods: the clinical data of 54 patients with RLNSS from October 2011 to December 2013 in the first affiliated Hospital of Nanchang University were analyzed retrospectively. The changes of glomerular filtration rate (GFR) were measured by single photon emission computed tomography (99mTc-DTPA) single photon emission computed tomography (SPECT) before and 3 months after operation. T-test, variance analysis and multiple linear regression analysis were used to analyze the possible factors affecting the recovery of renal function after operation. Results: all 54 cases of renal tumors were successfully operated, none of them were converted to open surgery. Tumor size 1.5-7.2cm (4.54 卤1.53). The operation time was 35-120min (57.09 卤14.09). The time of warm ischemia during operation was 0-42min (23.60 卤6.77). The estimated intraoperative blood loss (30-250ml) was 74.10 卤48.93). The renal GFR was (24.20 卤62.32) ml/min,11.23-57.45 (46.50 卤9.62) ml/min,11.23-57.45 (28.79 卤12.71) ml/min. before and 3 months after operation. The decrease of GFR after operation was (17.70 卤7.04) ml/min, which was 38.06% lower than that before operation. Multiple regression analysis showed that the renal function was significantly affected by pre-operative renal GFR (p < 0. 048), tumor diameter (P < 0. 001) and warm ischemia time (p < 0. 012). Conclusion: the diameter of renal GFR, tumor and the time of warm ischemia are the key factors affecting renal function after retroperitoneal laparoscopic nephrectomy.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11
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