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目的探讨腹腔镜肾部分切除术和开放手术治疗肾肿瘤对炎性因子及肾功能的影响。方法选取2013年1月至2015年10月中国医学科学院肿瘤医院泌尿外科收治的92例接受手术治疗的肾肿瘤患者,分为观察组和对照组,每组46例。观察组患者采用腹腔镜肾部分切除术,对照组患者采用开放手术。观察两组患者手术相关指标情况、感染性并发症发生率、炎性反应因子和肾功能变化。结果观察组术中出血量、术后引流量和住院时间均显著少于对照组(P<0.01);观察组术后感染性并发症发生率为4.4%,明显低于对照组的17.4%(P<0.05);观察组术后不同时间段白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均显著低于对照组(P<0.01);两组患者术后24 h血肌酐水平均较术前显著上升(P<0.01),观察组血肌酐水平显著低于对照组(P<0.01)。结论腹腔镜肾部分切除术治疗肾肿瘤,能够显著减轻手术创伤,有效抑制炎性反应因子,从而降低感染性并发症的发生,同时可减轻对术后早期肾功能的损伤程度。与开放手术治疗肾肿瘤比较,具有明显优势。
Objective To investigate the effects of laparoscopic partial nephrectomy and open surgery on inflammatory factors and renal function in renal tumors. Methods From January 2013 to October 2015, 92 patients with surgically treated renal tumors admitted to Department of Urology, Cancer Hospital, Chinese Academy of Medical Sciences were divided into observation group and control group, with 46 cases in each group. Laparoscopic partial nephrectomy was performed in observation group and open surgery was performed in control group. The operation-related indexes, incidence of infectious complication, inflammatory response and renal function were observed in the two groups. Results The intraoperative blood loss, postoperative drainage and hospital stay in observation group were significantly less than those in control group (P <0.01). The incidence of postoperative infectious complications in observation group was 4.4%, significantly lower than that in control group (17.4% P <0.05). The levels of IL-6, CRP and TNF-α in the observation group were significantly lower than those in the control group (P <0.01) ). Serum creatinine was significantly increased at 24 h after operation in both groups (P <0.01). The serum creatinine level in the observation group was significantly lower than that in the control group (P <0.01). Conclusions Laparoscopic partial nephrectomy for renal tumors can significantly reduce the surgical trauma and inhibit the inflammatory response factors, thus reducing the incidence of infectious complications and reducing the degree of early postoperative renal function damage. Compared with open surgery in the treatment of renal tumors, has obvious advantages.