【摘要】 目的 比较经腹腹腔镜单一体位肾输尿管全长切除术(PSPNTLR)与后腹腔镜下腹部切口技术(PLSIT)治疗上尿路上皮癌(UTUC)的临床疗效。方法 选取2018年1月—2021年2月河北医科大学第二医院收治的82例UTUC患者作为研究对象，采用随机数字表法将患者分为观察组(给予PSPNTLR治疗)和对照组(给予PLSIT治疗)各41例。比较两组患者围术期指标、疼痛程度、炎症因子水平和膀胱内复发和远处转移情况。结果 两组的手术时间[(122.15±15.14)min vs.(160.88±17.26)min]、住院时间[(10.07±2.14)d vs.(12.22±3.13)d]和术后排气时间[(1.46±0.57)d vs.(3.10±0.88)d]相比，观察组均明显短于对照组，两组的术中出血量[(42.85±4.88)mL vs.(78.22±8.17)mL]、引流量[(53.61±9.74)mL vs.(81.56±11.06)mL]相比，观察组均明显少于对照组(P<0.05)。观察组术后6、12及24 h的视觉模拟评分(VAS)均显著低于对照组(P<0.05)。术后1 d两组患者的白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均上升，但对照组指标上升更显著(P<0.05)。术后2年的随访期内，两组患者的膀胱内复发(12.20%vs.14.63%)和远处转移情况(9.76%vs.4.88%)比较差异无统计学意义(P>0.05)。结论 PSPNTLR与PLSIT治疗UTUC均有良好的安全性，但PSPNTLR在改善患者围术期指标、减轻患者术后疼痛、抑制机体炎症反应方面效果更优。更多还原

【Abstract】 Objective To compare the clinical efficacy of peritoneolaparoscopic single position nephreteral total length resection(PSPNTLR) and posterior laparoscopic subabdominal incision technique(PLSIT) in the treatment of upper urothelial carcinoma(UTUC).Methods A total of 82 UTUC patients treated in our hospital during Jan.2018 and Feb.2021 were divided into the observation group(n=41,treated with PSPNTLR) and control group(n=41,treated with PLSIT) according to the random number table method.Perioperative indicators, pain degree, inflammatory factors, bladder recurrence and distant metastasis were compared between the two groups.Results The operation time [(122.15±15.14) min vs.(160.88±17.26) min],hospitalization time [(10.07±2.14) d vs.(12.22±3.13) d] and postoperative exhaust time [(1.46±0.57) d vs.(3.10±0.88) d] were significantly shorter, the intraoperative blood loss [(42.85±4.88) mL vs.(78.22±8.17) mL] and drainage volume [(53.61±9.74) mL vs.(81.56±11.06) mL] were significantly less in the observation group than in the control group(P<0.05).The visual analogue score(VAS) of the observation group at 6,12 and 24 h after operation was significantly lower than that of the control group(P<0.05).The levels of interleukin-6(IL-6) and C-reactive protein(CRP) were increased in both groups one day after surgery, but the indexes were increased more significantly in the control group(P<0.05).During the 2-year follow-up after surgery, there were no statistical difference in bladder recurrence(12.20% vs.14.63%) and distant metastasis(9.76% vs.4.88%) between the two groups(P>0.05).Conclusion Both PSPNTLR and PLSIT have good therapeutic safety, but PSPNTLR is more effective in improving perioperative indicators, reducing postoperative pain, and inhibiting inflammatory factors.更多还原