后腹腔镜肾囊肿去顶减压术治疗成人型多囊肾对肾功能的影响

目的探讨后腹腔镜肾囊肿去顶减压术治疗成人型多囊肾中对术后肾功能的影响。方法 73例成人型多囊肾患者根据治疗方法分为观察组27例和对照组46例,观察组行后腹腔镜肾囊肿去顶减压术,对照组行常规开放性手术。比较2组手术时间、术中出血量、术后肠蠕动恢复时间、止痛药用量和住院时间及肾功能恢复情况。结果观察组手术时间（（51.01±12.85）min）、术中出血量（（57.05±24.05）mL）、术后肠蠕动恢复时间（（1.25±0.58）d）、止痛药用量（（54.21±15.87）mg）、住院时间（（5.04±1.25）d）均低于对照组（（78.08±16.89）min、（121.85±45.87）mL、（2.69±0.69）d、（124.65±34.40）mg、（7.39±2.14）d）（P〈0.01）;2组术后血肌酐、血尿素氮水平均较术前下降（P〈0.05）,但观察组术后1、3个月血肌酐（（214.03±42.25）、（191.01±21.85）μmol/L）、血尿素氮（（21.01±1.85）、（17.85±1.65）mmol/L）水平较对照组（血肌酐（239.39±41.02）、（214.07±23.09）μmol/L,血尿素（23.45±2.05）、（19.08±2.04）mmol/L）降低明显,差异有统计学意义（P〈0.01）。结论后腹腔镜肾囊肿去顶减压术治疗成人型多囊肾有助于提高术后肾功能恢复速度。

Influence of retroperitoneal laparoscopic renal cyst decortication on renal function in adult patients with polycystic kidney

Objective To investigate the influence of retroperitoneal laparoscopic renal cyst decortication on the renal function in adult patients with polycystic kidney.Methods Seventy-three adult patients with polycystic kidney were divided into observation group（n=27）receiving retroperitoneal laparoscopic renal cyst decortication and control group（n=46）receiving conventional open cyst decortication.The operation lasting time,intraoperative blood loss,enterocinesia recavery time,analgesics doses,hospitalization stay and renal function recovery degree were compared between two groups.Results The operation lasting time was shorter（（51.01±12.85）min）,intraoperative blood loss was less（（57.05±24.05）mL）,enterocinesia recovery time was shorter（（1.25±0.58）days）,analgesics doses was lower（（54.21±15.87）mg）,and hospitalization stay was shorter（（5.04±1.25）days）in observation group than those in control group（（78.08±16.89）min,（121.85±45.87）mL,（2.69±0.69）days,（124.65±34.40）mg,（7.39±2.14）days）（P〈0.01）.The serum creatinine and serum urea nitrogen level decreased after surgery in both groups（P〈0.05）.The levels of serum creatinine were（214.03±42.25）and（191.01±21.85）μmol/L,and the levels of serum urea nitrogen were（21.01±1.85）and 17.85±1.65）mmol/L in one and three months after surgery in observation group,significantly lower than those in control group（（239.39±41.02）μmol/L,（214.07±23.09）μmol/L,（23.45±2.05）mmol/L,（19.08±2.04）mmol/L）（P〈0.01）.Conclusion Retroperitoneal laparoscopic renal cyst decortication helps to improve the renal function in the treatment of adult polycystic kidney.