本文選題：腹腔鏡腎癌根治術(shù) + 經(jīng)腹途徑�。� 參考：《中國(guó)老年學(xué)雜志》2016年08期

【摘要】：目的前瞻性分析比較經(jīng)腹膜后途徑與經(jīng)腹途徑腹腔鏡腎癌根治術(shù)后老年患者肝功能的變化及原因。方法原發(fā)性老年腎癌患者61例,無(wú)其他腫瘤及肝臟疾病病史,腎腫瘤分期T1N0M0。經(jīng)腹膜后途徑腹腔鏡腎癌根治術(shù)31例,經(jīng)腹途徑腹腔鏡腎癌根治術(shù)30例。腫瘤平均直徑分別為(5.1±2.2),(4.8±1.7)cm。記錄手術(shù)前后肝功能的變化,比較手術(shù)對(duì)兩組患者肝功能的影響。結(jié)果兩組患者手術(shù)過(guò)程順利,經(jīng)腹膜后途徑組患者術(shù)后第1、3、7天肝功能各指標(biāo)接近正常。經(jīng)腹途徑組患者術(shù)后第1天丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)輕度增高,術(shù)后給予保肝藥物,第3天ALT、AST明顯下降,第7天ALT、AST恢復(fù)正常值,γ氨基酸轉(zhuǎn)肽酶(γ-GT),血清總膽紅素(TBIL)未發(fā)生明顯變化。結(jié)論經(jīng)腹膜后途徑腹腔鏡腎癌根治術(shù)對(duì)肝功能影響低于經(jīng)腹途徑腹腔鏡腎癌根治術(shù),腸道功能恢復(fù)快,提示經(jīng)腹膜后途徑手術(shù)創(chuàng)傷程度輕,恢復(fù)快。
[Abstract]:Objective to compare the changes and causes of liver function between retroperitoneal and transabdominal laparoscopic radical renal cell carcinoma patients. Methods 61 cases of primary renal cell carcinoma with no history of other neoplasms and liver diseases, T _ 1N _ (0) M _ (0). Retroperitoneal laparoscopic radical nephrectomy was performed in 31 cases and laparoscopy in 30 cases. The mean diameter of tumor was 5.1 鹵2.2 cm. The changes of liver function before and after operation were recorded and the effects of operation on liver function were compared between the two groups. Results the operation process of the two groups was smooth, and the liver function indexes of the patients in the retroperitoneal approach group were close to normal on the 1st day and 7th day after operation. In the transabdominal approach group, alanine aminotransferase (alt) and aspartate aminotransferase (AST) increased slightly on the first day after operation. On the 7th day, AST returned to normal value, but 緯 -amino acid transpeptidase (緯 -GTN), serum total bilirubin TBIL did not change significantly. Conclusion the effect of retroperitoneal laparoscopic radical nephrectomy on liver function is lower than that on abdominal laparoscopic radical renal cell carcinoma, and intestinal function recovers quickly, suggesting that retroperitoneal surgery is less traumatic and faster. [WT5HZ] [WT5 "BZ] [WT5" BZ] [WT5 "BZ] [WT5" BZ]
【作者單位】： 河北北方學(xué)院附屬第一醫(yī)院泌尿外科;河北北方學(xué)院檢驗(yàn)學(xué)院;張家口市沙嶺子醫(yī)院急診科;
【基金】：張家口市科學(xué)技術(shù)與發(fā)展指導(dǎo)計(jì)劃項(xiàng)目(1321124D) 河北北方學(xué)院青年基金項(xiàng)目(Q201126)
【分類號(hào)】：R737.11

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