本文選題：局限性腎癌 + 保留腎單位手術(shù)��； 參考：《河北聯(lián)合大學(xué)》2014年碩士論文

【摘要】：目的通過比較腎部分切除術(shù)（partial nephrectomy, PN）與根治性腎切除術(shù)（radical nephrectomy, RN）治療T1b期腎癌的臨床效果差異，來研究PN治療T1b期腎癌的優(yōu)越性與局限性。 方法回顧性分析武警后勤學(xué)院附屬醫(yī)院及其技術(shù)協(xié)作醫(yī)院2008年1月至2012年12月期間接受手術(shù)治療的T1b期腎癌病例92例，其中43例行PN治療，我們作為實(shí)驗(yàn)組，49例行RN治療，將其作為對(duì)照組。最后我們統(tǒng)計(jì)兩組的術(shù)中出血量、手術(shù)時(shí)間、術(shù)后住院時(shí)間、并發(fā)癥、復(fù)發(fā)率、生存率、術(shù)后1周及1月肌酐值，，并對(duì)它們進(jìn)行比較及流行病學(xué)分析。 結(jié)果手術(shù)時(shí)間、術(shù)中出血量、并發(fā)癥發(fā)生率實(shí)驗(yàn)組大于對(duì)照組有統(tǒng)計(jì)學(xué)差異(P0.05)；而術(shù)后一周肌酐值低于對(duì)照組有統(tǒng)計(jì)學(xué)差異(P 0.05)；術(shù)后住院時(shí)間、腫瘤復(fù)發(fā)率及長(zhǎng)期生存率、術(shù)后1月血肌酐值這些比較因素中兩組并無統(tǒng)計(jì)學(xué)差異（P㧐0.05）。 結(jié)論1在手術(shù)時(shí)間、術(shù)中出血量、術(shù)中及術(shù)后并發(fā)癥的發(fā)生率這些方面中，PN要高于RN(P 0.05)。在住院時(shí)間、腫瘤復(fù)發(fā)率及術(shù)后長(zhǎng)期存活率方面兩者未見明顯差異(P0.05)，而對(duì)于術(shù)后患者的腎功能，行RN的患者術(shù)后1周的血肌酐值要高于PN(P 0.05)，但隨著時(shí)間的推移，兩組未見明顯差異。(P0.05)。2PN可對(duì)患者腎單位盡可能的保留，可有效增強(qiáng)腎臟的代償能力，但對(duì)手術(shù)技巧要求過高，學(xué)習(xí)周期較長(zhǎng)。相信隨著醫(yī)學(xué)技術(shù)不斷發(fā)展，PN可成為治療局限性腎癌的首選術(shù)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.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.11

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 吳江濤;歐彤文;許建軍;崔昕;何新洲;;腹腔鏡超聲在微小腎癌保留腎單位手術(shù)中的臨床應(yīng)用[J];臨床泌尿外科雜志;2010年02期

2 孫光;;腎癌的診斷和手術(shù)治療進(jìn)展[J];現(xiàn)代泌尿外科雜志;2007年02期

3 劉國棟;劉曉;馬寶良;;腎臟小腫瘤診治進(jìn)展[J];現(xiàn)代泌尿外科雜志;2012年06期

4 楊立新;馬鳳巧;朱清;張立華;;低溫腎蒂阻斷保留腎單位手術(shù)治療小腎癌32例[J];山東醫(yī)藥;2010年46期

5 李泉林,關(guān)宏偉,張秋萍,薛波,韓輝,王法鵬,薛軍;腎細(xì)胞癌保腎手術(shù)安全切除范圍的探討[J];中華泌尿外科雜志;2002年12期

6 李學(xué)松;李淑清;何志嵩;郭應(yīng)祿;;射頻消融治療腎腫瘤[J];中華臨床醫(yī)師雜志(電子版);2007年07期

7 劉嘯;李輝;;保留腎單位治療在腎惡性腫瘤治療中的應(yīng)用[J];武警后勤學(xué)院學(xué)報(bào)(醫(yī)學(xué)版);2013年11期

本文編號(hào)：2033621