目的:探究腹腔镜肾部分切除术对老年局限性肾癌患者肾功能及炎性指标的影响.方法:选取我科2018年7月至2020年7月期间125例老年局限性肾癌患者作为研究对象,对照组62例给予开放性肾部分切除术,观察组63例给予腹腔镜肾部分切除术,观察两组患者的肿瘤清除效果,肾功能指标,炎性指标.结果:两组总有效率无统计学差异;对照组肌酐、尿素氮水平高于观察组(P<0.05),肾小球滤过率(Glomerular Filtration Rate,GFR)低于观察组(P<0.05),白介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive Protein,CRP)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、血沉水平均高于观察组(P<0.05).结论:腹腔镜肾部分切除术可降低肾脏损伤程度,调节炎性指标水平,肿瘤清除效果良好.

Objective:To investigate the effects of directly laparoscopic separation in urological retroperitoneal laparoscopic surgery.Methods:Between June 2017 and June 2019, 60 patients who underwent retroperitoneal laparoscopic surgery in the department of Urology at Changge People′s Hospital were enrolled in this study, including 35 males and 25 females, aged(45.12±12.65)years old, ranging from 25 to 66 years old.The patients were randomly divided into the direct separation group and self-made balloon group, with 30 cases in each group.In the direct separation group, the retroperitoneum was established by directly laparoscopic separation for retroperitoneal laparoscopic surgery, while in the self-made balloon group, the retroperitoneum was established by self-made gasbag for retroperitoneal laparoscopic surgery.The success rate and duration of retroperitoneum establishment, bleeding volume during cavity construction, operation duration, and the occurrence of postoperative complications were compared between the two groups.Results:The success rate of retroperitoneum establishment in the direct separation group was [96.7%(29/30)], higher than [73.3%(22/30)] in the self-made balloon group, the duration of retroperitoneum establishment and operation duration were [(6.26±1.21) minutes] and [(103.84±13.77) minutes], shorter than [(10.89±2.03) minutes] and [(126.45±15.65) minutes] in the self-made balloon group, and the bleeding volume during cavity construction was [(4.22±1.65) ml], less than [(8.73±1.52) ml] of the self-made balloon group, the incidence of complications in the direct separation group was [6.6%(2/30)], lower than [26.7%(8/30)] in the self-made balloon group, and the differences were statistically significant( P<0.05). Conclusion:Directly laparoscopic separation has significant clinical effects in urological retroperitoneal laparoscopic surgery.It is high success rate, less time-consuming, less bleeding, safe and reliable, which is worthy of clinical application.