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目的比较手助腹腔镜取肾术(HLDN)与开放手术取肾术(ODN)的临床效果。方法回顾性分析58例活体供肾取肾术手术资料。结果 58例供体中,ODN33例,HLDN25例。手术时间分别为(148±28)min和(138±42)min(P>0.05),术中出血量分别为(128±48)ml和(53±32)ml(P<0.05),热缺血时间分别为(1.6±0.3)min和(2.3±0.2)min(P<0.05)。ODN脾脏损伤1例,胸膜损伤1例,第12肋切除2例;HLDN未发生脏器损伤。ODN和HLDN术后7d时血肌酐分别为(88.6±23.7)μmol/L和(92.0±22.5)μmol/L(P>0.05)。平均住院时间为(10.4±2.8)d和(7.2±1.7)d(P<0.05)。结论在有良好的腹腔镜手术技术基础下,HLDN较ODN安全性好,术中操作方便、减少出血及周围脏器损伤,创伤小,缩短了住院时间。
Objective To compare the clinical effects of hand-assisted laparoscopic surgery (HLDN) with open surgery and kidney surgery (ODN). Methods Retrospective analysis of 58 cases of living donor kidney surgery data. Results In 58 donors, there were 33 cases of ODN and 25 cases of HLDN. The operative time was (148 ± 28) min and (138 ± 42) min respectively (P> 0.05). The amount of bleeding during the operation were (128 ± 48) ml and (53 ± 32) ml Blood time was (1.6 ± 0.3) min and (2.3 ± 0.2) min (P <0.05). 1 case of ODN spleen injury, 1 case of pleural injury, 2 cases of 12th rib resection; No organ injury occurred in HLDN. Serum creatinine was (88.6 ± 23.7) μmol / L and (92.0 ± 22.5) μmol / L, respectively, at 7 days after ODN and HLDN (P> 0.05). The average length of stay was (10.4 ± 2.8) days and (7.2 ± 1.7) days (P <0.05). Conclusions Under the condition of good laparoscopic surgery, HLDN is better than ODN in safety, convenient in operation, less bleeding and injury of surrounding organs, less trauma and shorter hospital stay.