R.E.N.A.L评分在后腹腔镜下肾部分切除术中预测肾脏热缺血时间的应用

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摘要 目的:探讨肾脏肿瘤测量评分系统(R.E.N.A.L评分)在后腹腔镜下肾部分切除术中预测肾脏热缺血时间的应用。方法:回顾性分析2011年1月~2013年3月162例行后腹腔肾部分切除手术(RLPN)患者的临床资料,其中男89例,女73例,年龄24~78岁,平均(55.4±7.5)岁。肿瘤平均直径(3.2±0.8)cm,其中左侧85例,右侧77例;背侧90例,腹侧72例;应用R.E.N.A.L评分系统对肾脏肿瘤进行量化评分。结果:162例患者中,其中低评分组有57例(35%),中评分组有97例(60%),高评分组有8例(5%),低、中与高评分组在肾脏热缺血时间、术中出血量、住院时间均差异有统计学意义(P＜0.05),在手术时间、并发症发生率差异无统计学意义(P＞0.05)。结论:后腹腔镜下肾部分切除术中高度复杂R.E.N.A.L评分的患者将显著增加肾脏热缺血时间,同时发现术中出血量、住院时间也较中低度复杂者有显著增加;因此R.E.N.A.L评分系统能够较好地评估腹腔镜下肾部分切除术的风险及手术难易程度。

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	叶剑青
	徐丹枫

关键词 ： R.E.N.A.L评分, 后腹腔镜, 肾部分切除术, 肾脏热缺血时间

Abstract：Objective:To evaluate R.E.N.A.L nephrometry score(RNS) for retroperitoneal laparoscopic partial nephrectomy(RLPN). Methods:Between January 2011 and March 2013,162 cases(89 males and 73 females) undergo RLPN. Mean age was(55.4±7.5)years,mean tumor size was(3.2±0.8)cm in diameter, with 85 cases on the left side and 77 cases on the right side.Tumor located anteriorly in 90 cases,and 72 cases were located posteriorly. RNS were evaluated. Results:Among the 162 cases,57(35%),97(60%),8(5%)were rated as low,moderate and high in complications.Stratidied by RNS,there were significant differences between patients of different RNS categories in the warm ischemia time(WIT), intraoperative blood loss, hospital stay(P＜0.05).There were no difference in overall operative time, complication rate(P＞0.05). Conclusions:In patients undergoing RLPN,a higher RNS was significantly associated with an increased estimated loss,warm ischemia time and length of hospital stay. RNS can well estimate surgical outcomes of RLPN.

Key words： R.E.N.A.L nephrometry score retroperitoneal laparoscopic partial nephrectomy renal warm ischemia time

收稿日期: 2013-08-27

ZTFLH:

R737.1

通讯作者: 徐丹枫,xudanfeng＠hotmail.com

作者简介: ^△共同第一作者

引用本文:

黄毅, 阴雷, 黄海, 高轶, 崔心刚, 王军凯, 叶剑青, 徐丹枫. R.E.N.A.L评分在后腹腔镜下肾部分切除术中预测肾脏热缺血时间的应用[J]. 微创泌尿外科杂志, 2013, 2(5): 324-327.
Huang Yi, Yin Lei, Huang Hai, Gao Yi, Cui Xingang, Wang Junkai, Ye Jianqing, Xu Danfeng. Application of R.E.N.A.L nephrometry score for retroperitoneal laparoscopic partial nephrectomy in predicting renal warm ischemia time. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(5): 324-327.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1060.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2013/V2/I5/324

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