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目的:探讨ABC肾肿瘤评分系统对肾部分切除术的临床应用价值。方法:通过筛选研究我院2013年1月~2015年5月施行腹腔镜下肾部分切除术的135位患者的临床资料,包括患者一般状况、围术期并发症情况及肾功能随访数据。根据患者术前CT/MR进行ABC系统评分,将患者分为低危组和高危组,分析ABC评分与肾脏热缺血时间(WIT)、术中出血量(EBL)、围手术期并发症、术后急性肾功能变化等相互关系。结果:ABC评分与WIT(P=0.002)、术中出血量(P<0.001)和围术期并发症(P=0.02)均有明显关系,亦与术后肾功能变化率(P=0.03)有明显相关性,但与术后3个月(P=0.06)、6个月(P=0.17)及12个月(P=0.34)的肾功能变化率也无明显相关性;术后3个月肾图也说明患侧分肾功能下降水平在ABC低危组及高危组的差异无明显统计学意义。结论:ABC评分系统是基于肾肿瘤和血管密切关系的一种简便评估方法,具有良好的临床应用性,能够帮助泌尿外科医生在术前进行围术期并发症及急性期肾功能损伤(AKI)的预测;但其评估远期肾功能的价值仍需进一步探究。
Objective: To investigate the clinical value of ABC Kidney tumor score system in partial nephrectomy. Methods: The clinical data of 135 patients undergoing laparoscopic partial nephrectomy from January 2013 to May 2015 in our hospital were screened, including the general condition, perioperative complications and renal function follow-up data. According to the preoperative CT / MR ABC score, the patients were divided into low-risk group and high-risk group, ABC score and renal warm ischemia time (WIT), intraoperative blood loss (EBL), perioperative complications, Postoperative acute renal function changes and other interrelations. RESULTS: The ABC score was significantly associated with WIT (P = 0.002), intraoperative blood loss (P <0.001) and perioperative complications (P = 0.02) as well as postoperative renal function changes (P = 0.03) (P = 0.06), 6 months (P = 0.17) and 12 months (P = 0.34). There was no significant correlation between the changes of renal function after 3 months Month kidney chart also shows the level of ipsilateral renal function decline in low-risk ABC group and high-risk group no significant difference between the statistically significant. Conclusion: The ABC scoring system is a simple and convenient evaluation method based on the close relation between renal tumor and blood vessel. It has good clinical applicability and can help urologists to perform perioperative complications and acute renal injury (AKI) However, its value in assessing long-term renal function still needs to be explored further.