B超引导下经皮肾镜双通道与腹腔镜下肾囊肿去顶术治疗单纯性肾囊肿的比较研究

doi:10.19558/j.cnki.10-1020/r.2019.05.003

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摘要 目的：比较B超引导下经皮肾镜双通道与腹腔镜下肾囊肿去顶术治疗单纯性肾囊肿的疗效。方法：选择2017年1月–2018年1月收治的单纯性背侧肾囊肿病例共90例,按手术方法分成经皮肾镜组与腹腔镜组,每组45例,比较两组患者一般临床资料、手术情况、术后第1、3天C反应蛋白（CRP）、白细胞介素6（IL-6）、降钙素原（PCT）浓度。结果：经皮肾镜组在性别、年龄、BMI指数、囊肿直径、囊肿位置上与腹腔镜组差异无统计学意义,两组间具有可比性。经皮肾镜组术中出血量少于腹腔镜组,手术时间,拔管时间,住院时间均短于腹腔镜组,术后12 h疼痛评分低于腹腔镜组,住院费用少于腹腔镜组,术后发热率低于腹腔镜组,差异有统计学意义,均P<0.05;两组在复发率及并发症发生率上差异无统计学义（P>0.05）。两组CRP、IL-6、PCT值均呈术后1 d升高、术后3 d降低的趋势,其中术后1 d及3 d经皮肾镜组CRP、IL-6、PCT值均显著低于腹腔镜组（P<0.05）。结论：经皮肾镜治疗单纯性肾囊肿与腹腔镜肾囊肿去顶术疗效相当,但创伤更小、住院时间更短、费用更低,并发症发生率更低。

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	谢赞兵
	李子祺
	黄冠银

关键词 ：经皮肾镜, 腹腔镜下肾囊肿去顶术, 肾囊肿

Abstract：Objective：To compare the efficacy of B-mode ultrasound-guided percutaneous nephroscopic double-channel and laparoscopic un-roofing for simple renal cysts. Methods：Ninety cases of simple renal cyst admitted to our hospital from January 2017 to January 2018 were divided into percutaneous nephroscopy group and laparoscopy group, 45 cases in each group. The general clinical data, surgical conditions, C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) levels 1 and 3 days after operation were compared between the two groups. Results： There was no significant difference in sex, age, BMI, cyst diameter and cyst location between the percutaneous nephroscopy group and the laparoscopy group. There were 35 cases of lumbar anesthesia, 10 cases of local anesthesia and 45 cases of general anesthesia in the laparoscopy group. Percutaneous nephroscopy group had less bleeding, shorter operation time, shorter extubation time, shorter hospitalization time, lower pain score at 12 h after operation, lower hospitalization cost and fever rate than laparoscopy group. The difference was statistically significant (P<0.05). There was no significant difference in recurrence rate and complication rate between the two groups (P>0.05). The CRP, IL-6 and PCT values in percutaneous nephroscopy group and laparoscopy group increased 1 day after operation and decreased 3 days after operation. The CRP, IL-6 and PCT values in percutaneous nephroscopy group were significantly lower than those in laparoscopy group on 1 and 3 days after operation (P<0.05). Conclusion： Percutaneous nephroscopy is as effective as laparoscopic un-roofing for simple renal cysts, but it has less trauma, shorter hospital stay, lower cost and lower incidence of complications.

Key words： percutaneous nephroscope laparoscopic un-roofing simple renal cysts

收稿日期: 2019-05-27

ZTFLH:

R692

基金资助:惠州市科技专项（180525121740604）

通讯作者: 谢赞兵,xiezanbing@21cn.com

引用本文:

谢赞兵, 李子祺, 黄冠银. B超引导下经皮肾镜双通道与腹腔镜下肾囊肿去顶术治疗单纯性肾囊肿的比较研究[J]. 微创泌尿外科杂志, 2019, 8(5): 298-302.
XIE Zanbing, LI Ziqi, HUANG Guanyin. A comparative study of B-mode ultrasound-guided percutaneous nephroscopic double-channel and laparoscopic un-roofing for simple renal cysts. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(5): 298-302.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1530.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2019/V8/I5/298

[1] 马鑫,张旭,董隽,等.机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术3例报告.微创泌尿外科杂志,2014,3(1):8-11.
[2] SMITH AD, CARSON JD, SIROUS R, et al.Active surveillance versus nephron-sparing surgery for a bosniak IIF or III renal cyst: a cost-effectiveness analysis. Am J Roentgenol, 2019,212(4):830-838.
[3] EISSA A, SHERBINY AE, MARTORANA E, et al.Non-conservative management of simple renal cysts in adults: a comprehensive review of literature. Minerva Urol Nefrol, 2018,70(2):179-192.
[4] 张欢,张俊,南小新,等.微创经皮肾镜碎石取石术治疗成人多囊肾合并肾结石20例分析.重庆医学,2014,43(1):98-99.
[5] 杨文增,宋士超,徐丽,等.经皮肾镜治疗肾结石合并单纯性肾囊肿疗效观察.天津医药,2013,41(5):498-499.
[6] 庞桂建,刘成倍,徐伟,等.腹腔镜下肾囊肿去顶减压同期直视下微创经皮肾镜取石术治疗肾结石合并肾囊肿.中国内镜杂志,2013,19(4):431-433.
[7] RICHARD PO, VIOLETTE PD, JEWETT MA, et al.CUA guideline on the management of cystic renal lesions. Can Urol Assoc J, 2017,11(3/4):E66-E73.
[8] RENSHAW A.The natural history of incidentally detected small renal masses. Cancer, 2004,101(3):650-651.
[9] TAY SY, TIU CM, HU B, et al.Characterization and management of various renal cystic lesions by sonographic features. J Chin Med Assoc, 2018,81(12):1017-1026.
[10] DESAI D, MODI S, PAVICIC M, et al.Percutaneous renal cyst ablation and review of the current literature. J Endourol Case Rep, 2016,2(1):11-13.
[11] AGARWAL M, AGRAWAL MS, MITTAL R, et al.A randomized study of aspiration and sclerotherapy versus laparoscopic deroofing in management of symptomatic simple renal cysts. J Endourol, 2012,26(5):561-565.
[12] 邓毕华,陈晓峰,陈善群.腹腔镜下肾囊肿去顶减压翻转术和去顶减压术的比较.当代医学,2019,25(10):64-67.
[13] 胡永文,李华英,陈奎.输尿管软镜下钬激光内切开引流术与后腹腔镜下囊肿去顶术治疗单纯性肾囊肿疾病的效果比较.中国当代医药,2019,26(10):98-100.
[14] 王星渊,曹德宏,陈泽昱,等.彩超引导下经皮穿刺硬化与腹腔镜去顶减压术治疗单纯性肾囊肿的Meta分析.现代泌尿外科杂志,2019,24(10):806-811.
[15] JENKINS TC, HAUKOOS JS, COTTON E, et al. Time course of C-reactive protein and procalcitonin levels during the treatment of acute bacterial skin infections. Open Forum Infect Dis, 2018,5(3):ofy029.
[16] CHING CB, GUPTA S, LI BR, et al.Interleukin-6/Stat3 signaling has an essential role in the host antimicrobial response to urinary tract infection. Kidney Int, 2018,93(6):1320-1329.
[17] CUSCHIERI J, BULGER E, SCHAEFFER V, et al.Early elevation in random plasma IL-6 following severe injury is associated with development of organ failure. Shock, 2010,34(4):346-351.
[18] SCHUETZ P, CHRIST-CRAIN M, WOLBERS M, et al.Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial. BMC Health Serv Res, 2007,7(1):102.
[19] HUANG DT, ANGUS DC, CHANG CH, et al.Design and rationale of the Procalcitonin Antibiotic Consensus Trial (ProACT), a multicenter randomized trial of procalcitonin antibiotic guidance in lower respiratory tract infection. BMC Emerg Med, 2017,17(1):25.