不同手术方式治疗肾上腺肿瘤的效果比较

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摘要目的比较不同手术方式治疗肾上腺肿瘤的临床效果。方法选取2008年1月～2018年1月我院收治的185例肾上腺肿瘤患者作为研究对象，按照手术方式的不同分为 A组（62例）、B组（62例）、C组（61例）。A、B、C组患者分别采用后腹腔入路腹腔镜手术、经腹入路腹腔镜手术、开放手术。比较三组患者的手术时间、术中出血量、术后下床活动时间、术后住院时间、术后肠道功能恢复时间、VAS疼痛评分；术后并发症发生率、输血率、患者满意度及术中中转开放手术率。结果 A、B组患者的术中出血量均显著少于C组（P＜0.05），但A、B组患者的术中出血量比较，差异无统计学意义（P＞0.05）；A组患者的手术时间、术后下床活动时间、术后住院时间、术后肠道功能恢复时间均显著短于B、C组，VAS疼痛评分均显著低于B、C组（P＜0.001）。A、B组患者的术后并发症总发生率、输血率均显著低于 C组（P＜0.0167）；A组患者的术后患者满意率显著高于 B、C组（P＜0.05）；A、B组患者的术中中转开放手术率比较，差异无统计学意义（P＞0.05）。结论后腹腔入路腹腔镜手术治疗肾上腺肿瘤具有切口小、术中出血少、患者术后恢复快、疼痛轻、输血率低和并发症少的优点，还可提高患者的满意度、舒适度，值得临床推广和应用。

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	朱陈辉
	黄海文
	杨水华
	高绍青
	许健斌
	蔡智仁

关键词 ：肾上腺肿瘤, 开放手术, 后腹腔入路, 经腹入路, 效果

Abstract：Objective To compare the clinical effect of the different surgical methods treating adrenal tumor.Methods A total of 185 patients with adrenal tumor treated in our hospital From January 2008 to January 2018 were selected as objects,and they were divided into group A(62 cases),group B(62 cases)and group C(61 cases)according to the different surgical methods.Patients in group A,B and C received retroperitoneal laparoscopic surgery,transabdominal laparoscopic surgery and open surgery respectively.The operative time,intraoperative bleeding volume,postoperative ambulation time,postoperative hospitalization time,postoperative intestinal function recovery time,VAS pain score,the incidence of postoperative complications,blood transfusion rate,satisfaction degree of patients and the rate of converting to open surgery during operation were compared among the three groups.Results The intraoperative bleeding volume of group A and group B were significantly less than that of group C (P<0.05),but there was no significant difference between group A and group B(P>0.05).The operative time,postoperative ambulation time,postoperative hospitalization time,postoperative intestinal function recovery time were significantly shorter than those in group B and group C,VAS pain score in group A was significantly lower than that in group B and group C (P<0.001).The incidence of postoperative complications and blood transfusion rate in group A and group B were significantly lower than those in group C(P<0.0167).The satisfaction rate of patients in group A was significantly higher than that in group B and C(P<0.05),and there was no significant difference in the rate of converting to open surgery during operation between group A and group B(P>0.05).Conclusion Retroperitoneal laparoscopic surgery treating adrenal tumor has the advantages of small incision,less bleeding,quick recovery,light pain,low blood transfusion rate and fewer complications.It can also improve the satisfaction and comfort of patients.It is worthy of clinical promotion and application.

Key words： Adrenal tumor Open surgery Retroperitoneal approach Transabdominal approach Effect

通讯作者: 黄海文（1971-），男，广东湛江人，本科，主任医师，科室主任，研究方向及专业擅长：泌尿系肿瘤、结石及男性不育

作者简介: 朱陈辉（1986-），男，广东湛江人，硕士，主治医师，研究方向及专业擅长：泌尿系肿瘤、结石及男性不育

引用本文:

朱陈辉;黄海文;杨水华;高绍青;许健斌;蔡智仁. 不同手术方式治疗肾上腺肿瘤的效果比较[J]. 中国当代医药, 2018, 25(26): 22-26.
ZHU Chen-hui;HUANG Hai-wen; YANG Shui-hua;GAO Shao-qing;XU Jian-bin;CAI Zhi-ren. Effect comparison of different surgical methods treating adrenal tumor. 中国当代医药, 2018, 25(26): 22-26.

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