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目的观察并探讨后腹腔镜囊肿去顶治疗多囊肾临床效果。方法回顾性分析我院2007年5月至2010年10月行后腹腔镜囊肿去顶治疗多囊肾患者43例临床治疗资料及随访观察结果,根据治疗前后腰部疼痛症状、血压及肾功能指标变化情况评价临床治疗效果。结果全部43例患者中42例顺利完成后腹腔镜囊肿去顶减压术,仅1例因病情需要转为开放手术治疗。手术时间为50～160min,平均手术时间为73.4min;术中出血量为20～74ml,平均术中出血量为45.7ml;术后住院时间为3～6d,平均住院时间为3.7d;术后囊肿复发2例,复发率为4.7%。术后眼部疼痛症状缓解患者39例,缓解率为90.7%;术后无腹腔感染,腹腔大出血及肠梗阻等病例出现;患者术后收缩压(128.1±10.7)mmHg,术后舒张压(81.0±13.5)mmHg,术后血肌酐(99.3±25.8)μmol/L,术后血尿素氮(9.8±2.1)mmol/L,各项检查指标较术前均明显降低,差异有统计学意义(P<0.05)。结论后腹腔镜囊肿去顶治疗多囊肾临床效果确切,具有微创,快速,操作简便等优点,能够有效缓解患者疼痛,降低血压,改善肾功能,值得在临床加以推广应用。
Objective To observe and discuss the clinical effect of retroperitoneal laparoscopic cyst removal in treating polycystic kidney disease. Methods A retrospective analysis of our hospital from May 2007 to October 2010 after retroperitoneal laparoscopic removal of polycystic kidney disease in 43 patients with clinical data and follow-up observation results, according to the treatment of lumbar pain symptoms, blood pressure and renal function changes Evaluation of the clinical effect of treatment. Results In all 43 patients, 42 cases were successfully completed laparoscopic cyst decompression surgery, only 1 case due to the need to be turned into open surgery. The operation time was 50 ~ 160min, the average operation time was 73.4min; the intraoperative blood loss was 20 ~ 74ml, the mean blood loss was 45.7ml; the postoperative hospital stay was 3 ~ 6d, the average hospital stay was 3.7d; Cyst recurrence in 2 cases, the recurrence rate was 4.7%. There were 39 patients with postoperative eye pain relief and the remission rate was 90.7%. There were no postoperative abdominal infection, intraperitoneal hemorrhage and intestinal obstruction. The postoperative systolic pressure (128.1 ± 10.7) mmHg, postoperative diastolic pressure (81.0% ± 13.5) mmHg, postoperative serum creatinine (99.3 ± 25.8) μmol / L and postoperative blood urea nitrogen (9.8 ± 2.1) mmol / L, all indexes were significantly lower than those before operation, the difference was statistically significant <0.05). Conclusions Retroperitoneal laparoscopic cyst removal of polycystic kidney disease has the exact clinical effect. It has the advantages of minimally invasive, rapid and simple operation. It can effectively relieve pain, reduce blood pressure and improve renal function. It is worth popularizing and applying in clinic.