腹腔镜下零缺血免缝合钬激光肾部分切除术的临床应用价值

发布时间：2018-03-28 19:06

本文选题：零缺血　切入点：免缝合　出处：《医学与哲学(B)》2017年11期

【摘要】：评价腹腔镜下零缺血免缝合钬激光肾部分切除术的临床应用价值,探讨该项技术在缩短术中肾脏缺血时间、减少肾脏组织损伤范围等方面的有效性及安全性。"零缺血"技术即术中不阻断肾动脉,"免缝合"技术即不用传统的缝线方式缝合肾脏创面止血,而是通过钬激光烧灼创面达到止血目的。根据笔者所在医院初期开展的腹腔镜下零缺血免缝合钬激光肾部分切除术及参考国内外相关文献报道情况,"零缺血"技术可最大程度减少肾脏热缺血时间,避免肾功损害,"免缝合"技术可有效减少肾脏组织损伤范围,"钬激光"应用于肾部分切除术,一方面可进行术中止血,避免对肾脏创面的缝合,另一方面相比传统的缝线缝合方式,钬激光对肾脏组织的损伤范围更小。将"零缺血"、"免缝合"、"钬激光"三种技术同时用于腹腔镜肾部分切除术,可最大程度避免术中肾功损害、减少肾脏组织的损伤范围。在掌握适应证的前提下,该项技术安全可靠,可以明显减少手术时间,缩短术中肾脏热缺血时间,减少肾脏组织的损伤范围。
[Abstract]:To evaluate the clinical value of laparoscopic holmium laser partial nephrectomy with zero ischemia free suture, and to explore the application of this technique in shortening the duration of renal ischemia during operation. The effectiveness and safety of reducing the extent of renal tissue injury. The "zero ischemia" technique means that the renal artery is not blocked during the operation, and the "no suture" technique is not used to suture the kidney wound to stop bleeding. The purpose of hemostasis is to be achieved by holmium laser cauterization. According to the laparoscopic partial nephrectomy with zero ischemia free suture under laparoscope and referring to the relevant literature reports at home and abroad, the technique of "zero ischemia" was used in our hospital. Surgery minimizes the duration of hot ischemia in the kidneys. In order to avoid renal damage, the technique of "suture free" can effectively reduce the range of renal tissue injury. Holmium laser can be used in partial nephrectomy. On the one hand, it can stop bleeding during operation and avoid the suture of kidney wound. On the other hand, holmium laser has a much smaller range of damage to kidney tissue than traditional suture suture. The three techniques of "zero ischemia", "no suture" and "holmium laser" are used in laparoscopic partial nephrectomy. It can avoid the damage of renal function and reduce the range of renal injury. On the premise of grasping the indication, the technique is safe and reliable, it can obviously reduce the operation time and shorten the time of hot ischemia of kidney during operation. Reduce the extent of kidney tissue damage.
【作者单位】：大连医科大学附属第一医院泌尿外科;
【基金】：2015年辽宁省自然科学基金(2015B017)
【分类号】：R737.11

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