多层螺旋CT血管成像联合术中超声在小肾癌保留肾单位手术中的应用价值

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Abstract Objective To investigate clinical value of ultrasound combined with multislice spiral CT angiography （MSCTA） in nephron sparing surgery （NSS） for small renal cancer. Methods Based on the usage of ultrasound combined with MSCTA, 65 cases diagnosed with small renal cell carcinoma from May 2014 to May 2016 in the Affiliated Hospital of Chengde Medical College were divided into two groups, experimental group and control group respectively. The experimental group was consisted of 33 cases and the control group included 32 cases. The following indicators were compared between the two groups: operative time, intraoperative blood loss, intraoperative thermal ischemia time, the small lesion detection rate during operation, postoperative time to remove the peritoneal drainage tube, average hospital stay after surgery, postoperative complication rate, positive rate of postoperative pathological margin, postoperative GFR of surgical kidney. Results Intraoperative findings of renal vascular variation rate was consistent with that of preoperative MSCTA. In the experimental group, one case of small lesions was revealed by intraoperative ultrasonography. One case of postoperative urinary leakage occurred in the control group. The operative time, intraoperative blood loss, intraoperative thermal ischemia time, postoperative time to remove the peritoneal drainage tube, positive rate of postoperative pathological margin, average hospital stay after surgery were less in the experimental group than the control group (P ＜ 0.05). GFR before and after surgery in the experimental group had no statistically significant difference （P ＞ 0.05）. The postoperative GFR of the control group was significantly lower than that before surgery （P ＜ 0.05）. Conclusion MSCTA combined with intraoperative ultrasonography control renal vessels more rapidly and reduce the risk of surgery and postoperative complications. The kidney units can also be retained to the maximum extent. It has good prognosis and great value in clinical application.

Key words： Small renal cell carcinoma Nephron sparing surgery Multislice spiral CT angiography Intraoperative ultrasound

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	SONG Dianbin1 XU Hui1 ZHANG Jingjing2 WANG Zhiyong1 LI Hongyang1 CHI Qiang1 MA Guang1 LIU Ying1

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SONG Dianbin1 XU Hui1 ZHANG Jingjing2 WANG Zhiyong1 LI Hongyang1 CHI Qiang1 MA Guang1 LIU Ying1. The application value of ultrasound combined with multi-slice spiral CT angiography in nephron sparing surgury for small renal cancer[J]. 中国医药导报, 2018, 15(27): 58-61.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I27/58

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