[1]王　磊,马　玲,葛玉坤,等.直径-轴距-极距肾肿瘤评分在腹腔镜肾部分切除术中的临床应用[J].新乡医学院学报,2020,37(2):165-169.[doi:10.7683/xxyxyxb.2020.02.015]
　WANG Lei,MA Ling,GE Yukun,et al.Clinical application of diameter-axial-polar renal tumor score in laparoscopic partial nephrectomy[J].Journal of Xinxiang Medical University,2020,37(2):165-169.[doi:10.7683/xxyxyxb.2020.02.015]
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直径-轴距-极距肾肿瘤评分在腹腔镜肾部分切除术中的临床应用
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年2
页码:
165-169
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Clinical application of diameter-axial-polar renal tumor score in laparoscopic partial nephrectomy
作者:
王　磊1; 马　玲2; 葛玉坤1; 乔庆东1; 李龚龙1; 冀　阳2; 李俊鹏1
(1.新乡市中心医院泌尿外一科，河南　新乡　453000；2.新乡市中心医院泌尿外二科，河南　新乡　453000)
Author(s):
WANG Lei1; MA Ling2; GE Yukun1; QIAO Qingdong1; LI Gonglong1; JI Yang2; LI Junpeng1
（1.Department of the First Urologic Surgery，the Central Hospital of Xinxiang，Xinxiang 453000，Henan Province，China；2.Department of the Second Urologic Surgery，the Central Hospital of Xinxiang，Xinxiang 453000，Henan Province，China）
关键词:
直径-轴距-极距肾肿瘤评分; 腹腔镜; 肾部分切除术; 肾肿瘤
Keywords:
diameter-axial-polar renal tumor score system; laparoscopy; partial nephrectomy; renal tumor
分类号:
R737.11
DOI:
10.7683/xxyxyxb.2020.02.015
文献标志码:
A
摘要:
目的　探讨直径-轴距-极距（DAP）肾肿瘤评分在腹腔镜肾部分切除术中的应用价值。方法　回顾性分析新乡市中心医院2013年1月至2019年8月收治的68例行腹腔镜肾部分切除术的单发肾肿瘤患者临床资料,分析DAP肾肿瘤评分与手术时间、肾脏热缺血时间、术中出血量、术后血红蛋白下降值、术后住院时间、围术期并发症及术后肾功能变化的关系。按照DAP肾肿瘤评分将患者分为低分值组38例（3~4分）、中分值组19例（5~6分）、高分值组11例（7~9分），比较3组患者临床特征的差异。结果　DAP评分与患者手术时间、热缺血时间、术中出血量、血红蛋白下降值、术后1 d血肌酐水平、术后1 d 肾小球滤过率估计值（eGFR）、术后住院时间相关（P<0.05），与患者年龄、性别、体质量指数（BMI）、术前血肌酐水平、术前eGFR及围术期并发症无关（P>0.05）。低分值组、中分值组和高分值组患者的性别、年龄、BMI、术前血肌酐水平、术前eGFR、术后住院时间及围术期并发症发生率比较差异均无统计学意义（P>0.05）。高分值组患者手术时间长于低分值组和中分值组（P＜0.05）;低分值组和中分值组患者手术时间比较差异无统计学意义（P>0.05）。中分值组和高分值组患者热缺血时间长于低分值组（P＜0.05），中分值组和高分值组患者热缺血时间比较差异无统计学意义（P>0.05）。高分值组患者术中出血量多于低分值组（P＜0.05），中分值组患者术中出血量与低分值组、高分值组比较差异均无统计学意义（P>0.05）。高分值组患者术后血红蛋白下降值高于低分值组（P＜0.05），中分值组患者术后血红蛋白下降值与低分值组、高分值组比较差异均无统计学意义（P>0.05）。高分值组患者术后1 d血肌酐水平和术后1 d eGFR高于低分值组和中分值组（P＜0.05）；低分值组和中分值组患者术后1 d血肌酐水平和术后1 d eGFR比较差异无统计学意义（P>0.05）。结论　DAP肾肿瘤评分系统能对腹腔镜肾部分切除术治疗单发肾肿瘤患者的围术期参数、手术难度及风险进行评估，评分高低与手术时间、热缺血时间等指标具有相关性；特别是高分值组患者的手术时间及热缺血时间更长，该结果可为临床肾肿瘤患者手术方式的选择提供参考。
Abstract:
Objective　To investigate the clinical application of diameter-axial-polar（DAP） renal tumor score in laparoscopic partial nephrectomy.Methods　The clinical data of 68 patients with single renal tumors who underwent laparoscopic partial nephrectomy in the Central Hospital of Xinxiang from January 2013 to August 2019 were analyzed retrospectively.The relationship between DAP renal tumor score and operation time,renal warm ischemia time,intraoperative blood loss,postoperative hemoglobin reduction value and postoperative hospital stay,perioperative complications and postoperative renal function were analyzed.The patients were divided into low score group(n=38，3-4 scores）,medium score group(n=19，5-6 scores） and high score group(n=11，2-9 scores） according to the DAP renal tumor score and the differences of clinical data of patients in the three groups were compared and analyzed.Results　DAP renal tumor score was correlated with operation time,warm ischemia time,intraoperative blood loss,hemoglobin reduction value,serum creatinine level,estimated glomerular filtration rate(eGFR) at one day after operation and hospitalization time after operation (P<0.05);but it was not correlated with the age,gender,body mass index (BMI),serum creatinine level before operation,eGFR before operation and perioperative complications(P>0.05).There was no significant difference in the gender,age,BMI,preoperative serum creatinine level,preoperative eGFR,postoperative hospital stay and perioperative complications between the low score group,middle score group and high score group (P>0.05).The operation time of patients in the high score group was longer than that in the low score group and middle score group(P<0.05),there was no significant difference in the operation time of patients between the low score group and middle score group (P>0.05).The warm ischemia time of patients in the high score group and middle score group was longer than that in the low score group(P<0.05),there was no significant difference in the warm ischemia time of patients between the high score group and middle score group(P>0.05).The intraoperative blood loss of patients in the high score group was more than that in the low score group(P<0.05),there was no significant difference in the intraoperative blood loss of patients between the middle score group and high score group,low score group(P>0.05).The hemoglobin reduction value of patients in the high score group was higher than that in the low score group(P<0.05),there was no significant difference in the hemoglobin reduction value of patients between the middle score group and high score group,low score group(P>0.05).The level of serum creatinine and eGFR of patients in the high group were higher than those in the low score group and the middle score group at one day after operatioin (P<0.05);there was no significant difference in the level of serum creatinine and eGFR of patients between the middle score group and low score group at one day after operatioin(P>0.05).Conclusions　DAP renal tumor score can evaluate the perioperative parameters,surgical difficulty and risk of patients with single renal tumor；especially in the patients with high score,the operation time and warm ischemia time are longer.The results of this study can provide a reference for the choice of operation mode in clinical renal tumor patients

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更新日期/Last Update: 2020-02-05