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肾动脉阻断对腹腔镜下保留肾单位术后肾功能的影响
引用本文:王养民,杨旭凯,李明国,王振.肾动脉阻断对腹腔镜下保留肾单位术后肾功能的影响[J].现代泌尿生殖肿瘤杂志,2016(3):132-135.
作者姓名:王养民  杨旭凯  李明国  王振
作者单位:730050,兰州军区兰州总医院泌尿外科
基金项目:甘肃省自然科学基金(145RJZA138)
摘    要:目的:探讨阻断肾动脉主干对腹腔镜下保留肾单位术后患者肾功能的影响.方法回顾分析因肾肿瘤行腹腔镜下保留肾单位手术患者的临床资料,根据术中肾动脉阻断时间、出血量、肿瘤分期、肿瘤病理、术后随访及肾小球滤过率变化,分析肾动脉阻断对保留肾单位手术后肾功能的影响.结果82例患者中,肾透明细胞癌75例,乳头状肾细胞癌3例,嫌色细胞癌4例;肾动脉阻断时间平均(24.5±8.6)min,术中失血量(249.4±66.9)ml.热缺血时间在25 min 以内的患者与26~30 min 患者比较,术后患肾肾功能受损差异无统计学意义(P >0.05);热缺血时间为31~40 min 的患者与前两组比较,术后患肾肾功能受损差异有统计学意义(P <0.05).结论保留肾单位手术均会使患侧肾功能下降,但阻断肾动脉主干热缺血时间控制在30 min 内对肾功能影响相对较小.

关 键 词:肾肿瘤  腹腔镜  保留肾单位手术  肾动脉阻断  肾功能

The influences of renal artery occlusion on renal function of patients accepted laparoscopic nephron sparing surgery
Abstract:Objective To investigate influence of renal artery occlusion on renal function of pa-tients accepted laparoscopic nephron sparing surgery. Methods Patients accepted laparoscopic par-tial nephrectomy at our hospital in recent years were retrospectively studied.We analyzed the influ-ence of renal artery occlusion on renal function with the relationship of intraoperative renal artery oc-clusion time,blood loss,tumor stage,tumor pathology,postoperative follow-up results,and chan-ges in GFR. Results There were 75 cases with renal cell carcinoma,3 cases with papillary renal cell carcinoma,and 4 cases with chromophobe cell carcinoma.The renal artery occlusion average time was (24.5±8.6)min.The intraoperative blood loss was (249.4±66.9)ml.There was no signifi-cant difference (P >0.05 )in postoperative renal dysfunction between two groups (warm ischemia time within 25 min and within 26-30 min).There was a significant difference (P <0.05)between the former two groups and the third group (warm ischemia time was 31-40 min). Conclusions It could pretect renal function by nephron sparing surgery.If hot ischemia time is within 30 min,there is lit-tle effect on renal function.
Keywords:Kidney neoplasms  Laparoscopes  Nephron sparing surgery  Renal artery occlusion  Renal function
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