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目的:探讨术中超声辅助下孤立肾肾癌保留肾单位手术对选择性肾动脉阻断以及确定肿瘤切缘的作用。方法:回顾2004～2011年先天性或获得性孤立肾肾细胞癌行保留肾单位手术患者资料,共7例术中采用超声多普勒确认肾段动脉阻断效果,并对肿瘤包膜边缘行超声检测从而进一步确定肿瘤切缘。术后1个月、6个月以及1年随访对比术前肾功能变化,并规律随访患者预后至今。结果:7例手术均成功行保留肾单位手术,超声引导检测下行选择性肾段动脉阻断5例,另2例采用单纯肾动脉干阻断下手术,术中超声发现肿瘤可疑卫星灶2例并指导切缘。术后6个月及1年随访肾功能与术前相比无明显下降,所有患者随访至今,平均随访45.4个月,均未见肿瘤复发或转移。结论:术中超声辅助下行保留肾单位手术是治疗孤立肾肾癌的理想方法,有助于肿瘤的准确切除和肾功能保护。
Objective: To investigate the effect of intraoperative ultrasound-assisted renal neoplasm retention nephron surgery on selective renal artery occlusion and to determine the tumor margin. Methods: From 2004 to 2011, patients with nephrotic neoplasms who had nephrotic nephropathy were randomly divided into 7 groups. Ultrasound Doppler was used to confirm the blocking effect of renal arteries, and the marginal line Ultrasound testing to further determine the tumor margin. Postoperative 1 month, 6 months and 1 year follow-up comparison of preoperative renal function changes, and regular follow-up of patients with prognosis so far. Results: In all 7 cases, nephron surgery was successfully performed. Ultrasound guided detection of 5 cases of selective renal artery occlusion of the descending artery, and the other 2 cases of simple renal artery occlusion surgery. Ultrasound detected 2 suspicious satellite tumors And guide the cut edge. After 6 months and 1 year follow-up renal function compared with no significant decline, all patients were followed up for an average of 45.4 months follow-up, no tumor recurrence or metastasis. Conclusion: Intraoperative ultrasound-assisted nephron-preserving surgery is an ideal method for the treatment of isolated renal cell carcinoma, contributing to the accurate tumor excision and renal function protection.