R.E.N.A.L评分系统与保留肾单位手术围手术期相关问题的关系
发布时间：2018-07-28 16:07
【摘要】：目的:讨论R.E.N.A.L评分系统和保留肾单位手术(NSS)的相关问题之间的关系。方法:采用回顾性分析的方法,纳入130例行NSS的肾肿瘤(Kindney Neoplasm,KD)患者的临床资料,行该类评分,讨论手术方式、热缺血时间、出血量、手术时间、手术并发症与该类评分之间的关系,并行统计学的分析。结果:按该类评分系统,低、中、高度复杂组分别有62(47.7%)、58(44.6%)、10(7.7%)例,行腹腔镜肾部分切除术的例数分别为:59例(95.1%)、26例(44.8%)、2例(20%),不同评分患者在手术方式上存在显著差异(P0.05)。按评分高低进行分层分析,行腹腔镜辅助下肾部分切除术的低、中度复杂肿瘤的热缺血时间平均为(18.6±5.8)min、(23.0±5.9)min,出血量的中位数分别为20m L、50m L,热缺血时间及出血量均随评分增加而增加,有统计学的差异(P0.05)。在开放肾部分切除术组中,不同评分类型的患者的热缺血时间、手术时间、术中出血量上的差异有统计学意义(P0.05)。两个手术组发生并发症的例术上与该类评分的高低并没有统计学上的差异(P0.05)。单因素分析NSS围手术期并发症的影响因素的结果提示:R.E.N.A.L评分越高、采用开放性保留肾单位手术、热缺血时间及手术时间越长以及术中出血量越多都会使并发症发生的几率增加(P0.05)。结论:R.E.N.A.l评分系统能客观地、有效地评估肾肿瘤的解剖学复杂程度,在一定程度上预估手术的难度和风险,从而对肾肿瘤治疗策略的选择起到指导作用。
[Abstract]:Objective: to discuss the relationship between R.E.N.A.L scoring system and (NSS) in nephron sparing surgery. Methods: the clinical data of 130 patients with Kindney NeoplasmKD (Kindney NeoplasmKD) who were treated with NSS were retrospectively analyzed, and the clinical data were evaluated. The operative methods, the time of hot ischemia, the amount of bleeding and the time of operation were discussed. The relationship between surgical complications and the score was analyzed statistically. Results: according to this kind of scoring system, there were 62 cases (47.7%), 58 cases (44.6%) and 10 cases (7.7%) in the low, middle and high complex group respectively, and the number of cases of laparoscopic partial nephrectomy were 59 cases (95.1%), 26 cases (44.8%) and 2 cases (20%), respectively. There were significant differences in the operation methods among the patients with different scores (P0.05). According to the grading, the mean warm ischemic time of laparoscopic assisted partial nephrectomy was (18.6 卤5.8) min, () 23.0 卤5.9 min, the median of bleeding was 20ml / L (50 mL), the time of hot ischemia and the amount of bleeding increased with the increase of score. There was statistical difference (P0.05). In the open partial nephrectomy group, there were significant differences in warm ischemia time, operation time and intraoperative bleeding volume among patients with different scoring types (P0.05). There was no statistical difference between the complications of the two groups and the score (P0.05). Univariate analysis showed that the higher the score of NSS perioperative complications was, the higher the score was, the longer the warm ischemia time, the longer the operation time and the more blood loss, the higher the probability of complications (P0.05). Conclusion the system can objectively and effectively evaluate the anatomical complexity of renal tumors and predict the difficulty and risk of surgery to a certain extent, and thus play a guiding role in the choice of treatment strategies for renal tumors.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.11
本文编号：2150835
[Abstract]:Objective: to discuss the relationship between R.E.N.A.L scoring system and (NSS) in nephron sparing surgery. Methods: the clinical data of 130 patients with Kindney NeoplasmKD (Kindney NeoplasmKD) who were treated with NSS were retrospectively analyzed, and the clinical data were evaluated. The operative methods, the time of hot ischemia, the amount of bleeding and the time of operation were discussed. The relationship between surgical complications and the score was analyzed statistically. Results: according to this kind of scoring system, there were 62 cases (47.7%), 58 cases (44.6%) and 10 cases (7.7%) in the low, middle and high complex group respectively, and the number of cases of laparoscopic partial nephrectomy were 59 cases (95.1%), 26 cases (44.8%) and 2 cases (20%), respectively. There were significant differences in the operation methods among the patients with different scores (P0.05). According to the grading, the mean warm ischemic time of laparoscopic assisted partial nephrectomy was (18.6 卤5.8) min, () 23.0 卤5.9 min, the median of bleeding was 20ml / L (50 mL), the time of hot ischemia and the amount of bleeding increased with the increase of score. There was statistical difference (P0.05). In the open partial nephrectomy group, there were significant differences in warm ischemia time, operation time and intraoperative bleeding volume among patients with different scoring types (P0.05). There was no statistical difference between the complications of the two groups and the score (P0.05). Univariate analysis showed that the higher the score of NSS perioperative complications was, the higher the score was, the longer the warm ischemia time, the longer the operation time and the more blood loss, the higher the probability of complications (P0.05). Conclusion the system can objectively and effectively evaluate the anatomical complexity of renal tumors and predict the difficulty and risk of surgery to a certain extent, and thus play a guiding role in the choice of treatment strategies for renal tumors.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.11
【参考文献】
相关期刊论文 前1条
1 赵强;张骞;金杰;;后腹腔镜下肾部分切除术在单侧多中心性肾肿瘤治疗中的应用[J];中华泌尿外科杂志;2014年04期
，本文编号：2150835
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