改良型DAP评分系统在腹腔镜肾部分切除术治疗T1 期肾细胞癌中的应用

Application of modiffed DAP scoring system in patients with T1 renal cell carcinoma undergoing laparoscopic partial nephrectomy

关键词:  肾细胞癌  肾部分切除术  腹腔镜  DAP评分

Key words:  renal cell carcinoma  partial nephrectomy  laparoscopy  DAP scoring system

摘要:

目的　探讨改良型DAP评分系统在腹腔镜肾部分切除术治疗T1 期肾细胞癌中的临床意义。方法　179 例 T1 期肾细胞癌患者分别采用DAP和改良型DAP评分系统进行术前评分，并将两者评分与腹腔镜下肾部分切除术难度、 围手术期相关因素进行比较。结果　DAP评分系统分组与实际手术难度分组之间差异有统计学意义（P<0.05），但改良型 DAP评分系统分组与实际手术难度分组之间差异无统计学意义（P>0.05）。改良型DAP评分系统不同分组患者的手术时 间、术中热缺血时间和手术前后血红蛋白差异有统计学意义（P<0.05），但与手术前后肌酐差异值、术后引流管留置时间和 术后住院时间差异均无统计学意义（P>0.05）。结论　改良型DAP评分系统较DAP评分系统可较准确预测T1 期肾细胞 癌患者腹腔镜下肾部分切除手术难度，如手术时间、肾热缺血时间、出血量。

Abstract:

Objective　To investigate the application of modified DAP scoring system in laparoscopic partial nephrectomy (LPN) for T1 renal cell carcinoma (RCC). Methods　A total of 179 RCC patients were preoperatively evaluated by DAP and modified DAP scoring systems. Both scores were compared with the actual difficulty of LPN and perioperative related factors. Results　The actual operation difficulty was compatible for modified DAP (P>0.05) but not for DAP scores (P<0.05). The modified DAP scores were associated with operative time, intraoperative warm ischemia time and pre/postoperative hemoglobin (P<0.05) and not with pre/postoperative creatinine, postoperative drainage tube indwelling time and postoperative hospital stay (P>0.05). Conclusion　The modified DAP scoring system is superior to DAP scoring system in predicting the difficulty of LPN in patients with T1 RCC, such as operation time, renal warm ischemia time and blood loss.