【摘要】：目的：回顧性分析腹腔鏡下保留腎單位手術(shù)的腎細(xì)胞癌患者的腫瘤R.E.N.A.L評(píng)分、術(shù)中熱缺血時(shí)間與圍手術(shù)期并發(fā)癥發(fā)生情況之間的關(guān)系。 方法：本研究調(diào)查了2012年3月至2014年4月期間在中南大學(xué)湘雅二醫(yī)院接受腹腔鏡下保留腎單位手術(shù)的116名腎細(xì)胞癌患者的病歷資料,從中提取每位患者的年齡、性別、術(shù)前腫瘤評(píng)估資料、術(shù)中熱缺血時(shí)間與圍手術(shù)期并發(fā)癥發(fā)生情況等信息,同時(shí)調(diào)取了每位患者相應(yīng)的原始影像學(xué)資料,并對(duì)每位患者的腫瘤形態(tài)學(xué)特點(diǎn)(如大小、部位等)進(jìn)行了量化評(píng)估,根據(jù)R.E.N.A.L評(píng)分方法為每位患者的腫瘤予以評(píng)分。根據(jù)患者的腫瘤評(píng)估得分,將其分為低(4-5分)、中(6-7分)、高(8-9分)三個(gè)復(fù)雜度組；研究者從患者的圍手術(shù)期病程記錄與術(shù)后醫(yī)囑資料中對(duì)每位患者圍手術(shù)期的恢復(fù)情況進(jìn)行了解,并根據(jù)Accordion并發(fā)癥分級(jí)標(biāo)準(zhǔn)將每位患者的圍手術(shù)期并發(fā)癥進(jìn)行分級(jí)。 結(jié)果：低、中、高度復(fù)雜組分別入組患者30人、56人、30人,三組患者在平均年齡與性別構(gòu)成上均無(wú)顯著性差異,低度復(fù)雜組患者與中、高度復(fù)雜組患者之間在體重指數(shù)上存在顯著差異,中、高度復(fù)雜組之間的差異無(wú)統(tǒng)計(jì)學(xué)意義；低、中、高度復(fù)雜組的平均熱缺血時(shí)間分別為24.4分鐘、20.0分鐘與27.8分鐘,各組兩兩之間的差異均具有統(tǒng)計(jì)學(xué)意義。所有患者圍手術(shù)期并發(fā)癥等級(jí)最高為Ⅲ級(jí),Ⅱ級(jí)并發(fā)癥與Ⅲ級(jí)并發(fā)癥的發(fā)生率在三組之間沒有顯著差異。 結(jié)論：腎細(xì)胞癌患者R.E.N.A.L得分越高,術(shù)中熱缺血時(shí)間越長(zhǎng)；R.E.N.A.L得分9分以內(nèi)的患者,其得分與并發(fā)癥的發(fā)生率無(wú)明確關(guān)系,且圍手術(shù)期并發(fā)癥均可通過(guò)保守處理獲得良好控制。
[Abstract]:Objective: to retrospectively analyze the relationship between tumor R.E.N.A.L score, intraoperative hot ischemia time and perioperative complications in patients with renal cell carcinoma undergoing laparoscopic nephron-sparing surgery. Methods: from March 2012 to April 2014, 116 patients with renal cell carcinoma underwent laparoscopic nephron-sparing surgery in Xiangya second Hospital of Central South University were investigated, and the age and sex of each patient were extracted. Preoperative tumor evaluation data, intraoperative hot ischemia time and perioperative complications were obtained. Corresponding original imaging data of each patient were obtained, and morphologic features of each patient (such as size, etc.) A quantitative assessment was performed and each patient's tumor was graded according to the R.E.N.A.L scoring method. According to the patients' tumor evaluation scores, they were divided into three groups: low (4-5), middle (6-7) and high (8-9) complexity groups. The recovery of each patient during perioperative period was investigated from the patient's perioperative course record and doctor's advice, and each patient's perioperative complications were graded according to the Accordion complication classification standard. Results: there were 30 patients, 56 patients and 30 patients in the low, middle and high complex groups, respectively. There was no significant difference in average age and gender composition among the three groups, but there was no significant difference between the patients in the low complex group and in the middle group. There was significant difference in body mass index between the patients in the highly complex group, but there was no significant difference between the middle and the highly complex groups. The mean time of hot ischemia was 24.4 minutes, 20.0 minutes and 27.8 minutes in the low, middle and high complex groups, respectively. The difference between the two groups was statistically significant. The grade of perioperative complications was the highest in all patients, and there was no significant difference between the two groups in the incidence of grade 鈪，

本文編號(hào)：2368218