本文選題：球囊導(dǎo)管　切入點：低溫灌注　出處：《介入放射學(xué)雜志》2017年05期

【摘要】：目的評價腹腔鏡腎部分切除術(shù)前行腎動脈球囊導(dǎo)管置入術(shù)進行低溫灌注的可行性和安全性。方法選取解放軍總醫(yī)院2013年3月至2016年12月35例擬行腹腔鏡腎臟腫瘤部分切除術(shù)患者,腫瘤位于左腎22例,右腎13例,腫瘤長徑2.3~7.0 cm,平均(4.1±1.2)cm。切除術(shù)前行腎動脈球囊導(dǎo)管置入術(shù),術(shù)中經(jīng)球囊導(dǎo)管灌注4℃低溫液體,記錄切除術(shù)中腎臟冷缺血時間,手術(shù)時間,術(shù)中出血量,比較術(shù)前,術(shù)后第1、3、7天肌酐清除率(Ccr)和腎小球濾過率估值(e GFR),統(tǒng)計術(shù)中及術(shù)后并發(fā)癥。結(jié)果35例患者腎動脈球囊導(dǎo)管均置入成功,技術(shù)成功率100%。1例患者行切除術(shù)前球囊導(dǎo)管滑脫,2例術(shù)中發(fā)現(xiàn)阻斷不全另使用動脈鉗阻斷,另32例成功行單純腎動脈球囊導(dǎo)管低溫灌注下腹腔鏡腎部分切除術(shù),術(shù)中及術(shù)后均未出現(xiàn)嚴重并發(fā)癥�；寄I冷缺血時間平均45(20~125)min;介入手術(shù)時間平均28(20~40)min;外科手術(shù)時間平均147(95~235)min;術(shù)中出血量平均180(50~1 000)ml;術(shù)前,術(shù)后第1、3、7天Ccr分別為(96.5±15.1)、(75.2±10.5)、(54.3±13.8)、(91.8±14.1)ml/min,e GFR分別為(99.5±15.3)、(70.3±12.5)、(65.5±11.7)、(96.8±12.3)ml·min-1·1.73 m-2。經(jīng)統(tǒng)計分析,術(shù)前、術(shù)后第7天Ccr和e GFR值分別同術(shù)后第1、3天值相比較,兩組均存在統(tǒng)計學(xué)差異(P0.01),術(shù)前同術(shù)后第7天比較,兩組均無明顯統(tǒng)計學(xué)差異(P0.05)。結(jié)論腹腔鏡腎部分切除術(shù)前行腎動脈球囊導(dǎo)管低溫灌注安全、可行,有利于延長腎缺血時間、保護腎功能。
[Abstract]:Objective to evaluate the feasibility and safety of renal artery balloon catheter implantation before laparoscopic partial nephrectomy for hypothermia perfusion. Methods from March 2013 to December 2016, 35 patients with renal tumors undergoing laparoscopic renal surgery in PLA General Hospital were selected. Partial resection, The tumor was located in the left kidney in 22 cases and in the right kidney in 13 cases, with a mean length of 2.37.0 cm, with an average of 4.1 鹵1.2 cm. Before resection, the renal artery balloon catheter was implanted, the hypothermia fluid was perfused through the balloon catheter at 4 鈩，

本文編號：1700640