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目的分析肾脏部分切除手术治疗T1a期肾癌疗效及对肾功能的影响。方法选取汕头大学医学院第一附属医院2014年4月-2016年4月接受治疗的T1a期肾癌患者70例。随机分为观察组和对照组各35例,观察组行部分肾切除手术,对照组行根治肾切除手术。观察两组手术的时间及术中出血量。术后随访3个月观察两组患者肾功能状况。结果对照组手术所用的时间明显低于观察组,差异有统计学意义(P<0.05)。两组患者在手术过程中的出血量相比,差异无统计学意义(P>0.05)。术前1 d两组患者尿素氮(BUN)、内生肌酐清除率(Ccr)及肾小球滤过率(GFR)比较,差异均无统计学意义(P>0.05)。手术后1 d及术后3个月观察组血清中尿素氮(BUN)明显低于对照组,Ccr和GFR明显高于对照组,差异均有统计学意义(P<0.05)。结论肾脏部分切除手术治疗T1a期肾癌与根治切除手术相比,可以更好地保留肾功能,值得临床上推荐使用。
Objective To analyze the effect of partial nephrectomy on T1a renal cell carcinoma and its effect on renal function. Methods Seventy patients with stage T1a renal cell carcinoma who received treatment from April 2014 to April 2016 were selected from the First Affiliated Hospital of Shantou University Medical College. 35 cases were randomly divided into observation group and control group. The observation group underwent partial nephrectomy and the control group underwent radical nephrectomy. The operation time and intraoperative blood loss of the two groups were observed. The patients were followed up for 3 months to observe the renal function of the two groups. Results The operation time of the control group was significantly lower than that of the observation group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the amount of bleeding during the operation (P> 0.05). The levels of BUN, Ccr and glomerular filtration rate (GFR) in the two groups before operation were not statistically significant (P> 0.05). Blood urea nitrogen (BUN) in observation group was significantly lower than that in control group on day 1 and 3 after operation, and Ccr and GFR were significantly higher than those in control group (P <0.05). Conclusion Partial nephrectomy for T1a renal cell carcinoma can better retain renal function than radical resection, which is worth recommending for clinical use.