文章摘要
段良斌,胡仁广,王 凯,杨 东,张 义,喻 华,钱辉军.肾脏部分切除手术对T1a期肾癌患者炎性因子与肝肾功能的影响[J].,2018,(21):4156-4159
肾脏部分切除手术对T1a期肾癌患者炎性因子与肝肾功能的影响
Effects of Partial Nephrectomy on the Serum Inflammatory Factors Levels, Liver and Kidney Function of T1a Patients with Kidney Cancer
投稿时间:2018-02-04  修订日期:2018-02-27
DOI:10.13241/j.cnki.pmb.2018.21.035
中文关键词: 肾癌  肾脏部分切除术  炎性因子  肝功能  肾功能
英文关键词: Kidney cancer  Partial nephrectomy  Inflammatory factors  Liver function  Kidney function
基金项目:湖北省自然科学基金项目(20120531)
作者单位E-mail
段良斌 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300 bingsen99@163.com 
胡仁广 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300  
王 凯 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300  
杨 东 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300  
张 义 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300  
喻 华 汉川市人民医院(武汉大学人民医院汉川医院) 泌尿外科 湖北 汉川 432300  
钱辉军 武汉大学人民医院 泌尿外科 湖北 武汉 430060  
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中文摘要:
      摘要 目的:探讨肾脏部分切除手术对T1a期肾癌患者炎性因子与肝肾功能的影响。方法:回顾性分析我院2013年6月至2016年12月收治的91例T1a期肾癌患者的临床资料,按治疗方式不同分为对照组与试验组,对照组48例接受后腹腔镜根治性肾癌切除术治疗,试验组43例接受后腹腔镜肾脏部分切除手术治疗。比较两组的手术指标、治疗前后血清炎性因子、肝肾功能的变化及并发症发生情况。结果:对照组的手术时间、术中出血量均少于试验组(P<0.05)。治疗后,试验组血清IL-1变化值低于对照组[(-19.47±-2.57)μg/L比(-41.61±-6.38)μg/L]、IL-6变化值低于对照组[(-8.71±-1.05)ng/L比(-18.96±-3.10)ng/L]、CRP变化值低于对照组[(-12.72±-1.54)mg/L比(-17.46±-2.64)mg/L]、TNF-α变化值低于对照组[(-5.66±-0.15)ng/L比(-14.33±-2.04)ng/L]、BUN变化值低于对照组[(-1.53±-0.19)mmol/L比(-3.01±-0.79)mmol/L]、AST变化值低于对照组[(-15.29±-2.46)U/L比(-33.70±-3.78)U/L]、ALT变化值低于对照组[(-19.46±-2.27)U/L比(-34.02±-5.51)U/L],试验组Ccr变化值低于对照组[(19.78±2.94)mL/min比(28.26±3.52)mL/min]、GFR变化值低于对照组[(14.45±1.48)mL/min比(29.36±1.91)mL/min],除CRP和GFR外,其余指标差异均有统计学意义(P<0.05)。对照组和试验组并发症发生率分别为16.67%(8/48)和9.30%(4/43),两组比较差异无统计学意义(P>0.05)。结论:后腹腔镜肾脏部分切除手术治疗T1a期肾癌患者的临床效果优于后腹腔镜根治性肾癌切除术治疗,其对患者炎性因子及肝肾功能的影响较小,安全性更高。
英文摘要:
      ABSTRACT Objective: To investigate the effects of the partial nephrectomy on inflammatory factors, liver and kidney function in patients with kidney cancer at T1a stage. Methods: Retrospective analysis of 91 cases of patients with kidney cancer at T1a stage from June 2013 to December 2016. According to the different treatments, patients were divided into control group and experimental group. 48 cases of patients selected as control group, were treated with posterior laparoscopic radical nephrectomy therapy; 43 cases of patients set as treatment group, which were treated with posterior laparoscopic partial nephrectomy. The changes of serum inflammatory factors before and after treatment, liver and kidney function and complications in the both group were compared. Results: The operation time and intra- operative blood of control group were lower than the experimental group, the difference was statistically significant (P<0.05). The levels of serum IL-1 (-19.47±-2.57)μg/L vs (-41.61±-6.38)μg/L, IL-6 (-8.71±-1.05)ng/L vs (-18.96±-3.10)ng/L, CRP (-12.72±-1.54)mg/L vs (-17.46±-2.64)mg/L, TNF-α (-5.66±-0.15) ng/L vs (-14.33±-2.04)ng/L, BUN (-1.53±-0.19) mmol/L vs (-3.01±-0..79) mmol/L, AST (-15.29±-2.46)U/L vs (-33.70±-3.78)U/L, ALT (-19.46±-2.27)U/L vs (-34.02±-5.51)U/L, Ccr (19.78±2.94)mL/min vs (28.26±3.52)mL/min, and GFR (14.45±1.48)mL/min vs (29.36±1.91)mL/min, were all lower in treatment group than in control group. Except for CRP and GFR, the differences of all the items between the two groups were statistically significant (P<0.05). Complication rate of the control group and the experimental group was 16.67%(8/48) and 9.30% (4/43), there was no significantly differences in both group (P>0.05). Conclusion: The clinical effect of partial nephrectomy with retroperitoneoscope in treating T1a stage renal cancer is bet- ter than that of radical nephrectomy with retroperitoneoscope, it has little effect on the inflammatory factors and liver and kidney function, more secure.
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