發(fā)布時(shí)間：2018-03-28 19:06

  本文選題：零缺血　切入點(diǎn)：免縫合　出處：《醫(yī)學(xué)與哲學(xué)(B)》2017年11期

【摘要】：評(píng)價(jià)腹腔鏡下零缺血免縫合鈥激光腎部分切除術(shù)的臨床應(yīng)用價(jià)值,探討該項(xiàng)技術(shù)在縮短術(shù)中腎臟缺血時(shí)間、減少腎臟組織損傷范圍等方面的有效性及安全性。"零缺血"技術(shù)即術(shù)中不阻斷腎動(dòng)脈,"免縫合"技術(shù)即不用傳統(tǒng)的縫線方式縫合腎臟創(chuàng)面止血,而是通過鈥激光燒灼創(chuàng)面達(dá)到止血目的。根據(jù)筆者所在醫(yī)院初期開展的腹腔鏡下零缺血免縫合鈥激光腎部分切除術(shù)及參考國內(nèi)外相關(guān)文獻(xiàn)報(bào)道情況,"零缺血"技術(shù)可最大程度減少腎臟熱缺血時(shí)間,避免腎功損害,"免縫合"技術(shù)可有效減少腎臟組織損傷范圍,"鈥激光"應(yīng)用于腎部分切除術(shù),一方面可進(jìn)行術(shù)中止血,避免對腎臟創(chuàng)面的縫合,另一方面相比傳統(tǒng)的縫線縫合方式,鈥激光對腎臟組織的損傷范圍更小。將"零缺血"、"免縫合"、"鈥激光"三種技術(shù)同時(shí)用于腹腔鏡腎部分切除術(shù),可最大程度避免術(shù)中腎功損害、減少腎臟組織的損傷范圍。在掌握適應(yīng)證的前提下,該項(xiàng)技術(shù)安全可靠,可以明顯減少手術(shù)時(shí)間,縮短術(shù)中腎臟熱缺血時(shí)間,減少腎臟組織的損傷范圍。
[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.
【作者單位】： 大連醫(yī)科大學(xué)附屬第一醫(yī)院泌尿外科;
【基金】：2015年遼寧省自然科學(xué)基金(2015B017)
【分類號(hào)】：R737.11

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