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目的:本研究提出1个标准化的评分系统来评价肿瘤营养血管的解剖特征,并评价该评分系统对于腹腔镜下肾部分切除术中肾动脉分支阻断(segmental renal artery clamping,SRAC)术前评估的效果。方法:该评分系统包括5个参数。每个分数的权重(coefficient,C),肿瘤营养靶血管的阻断位置以及靶血管进入肾窦的位置(location,L),包括前半部分(anterior boundary,A)、跨区域(multi-boundary,M)以及后半部分(posterior boundary,P)。综合每个首字母组成本评分系统C.L.A.M.P.评分系统。回顾性研究106例接受SRAC患者的临床资料,并根据C.L.A.M.P.不同分值将患者分成低难度、中难度、高难度3组。结果:各组转至肾动脉主干阻断的比例以及阻断成功率差异均有统计学意义。然而术中失血、热缺血时间以及术后住院时间差异无统计学意义。结论:C.L.A.M.P.评分系统能够区别不同难度的SRAC,并且在识别适合行SRAC的患者方面有良好的预测能力。
OBJECTIVE: In this study, a standardized scoring system was proposed to evaluate the anatomic features of nutrient vessels in tumors and evaluate the preoperative assessment of segmental renal artery clamping (SRAC) in laparoscopic partial nephrectomy Effect. Method: The scoring system includes 5 parameters. The coefficient of each score (C), the site of blockage of the tumor target vessel and the location of the target vessel into the renal sinus, including the anterior boundary (A), multi-boundary M) and the posterior boundary (P). Consolidate each C.A.M.P. scoring system. The clinical data of 106 SRAC patients were retrospectively studied. According to C.L.A.M.P. different scores, patients were divided into 3 groups with low difficulty, moderate difficulty and high difficulty. Results: There were significant differences in the proportions of the block of renal artery transferred to the renal artery and the success rate of blockage between the groups. However, intraoperative blood loss, warm ischemia time and postoperative hospital stay were not significantly different. CONCLUSIONS: The C.L.A.M.P. scoring system is capable of distinguishing SRACs of varying difficulty and has good predictive power in identifying patients eligible for SRAC.