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目的:评价后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的临床价值。方法:回顾分析后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿18例(A组)及开放组20例(B组)的临床资料。结果:手术操作时间分别为A组(76±31)min、B组(113±26)min;手术中出血量A组(25±29)ml、B组(190±76)ml;术后肠功能恢复时间A组(33±9)h、B组(69±14)h;术后下床活动时间A组(39±8)h、B组(74±12)h;术后住院天数A组(6.7±2.5)天、B组(1 2.4±4.1)天;住院总天数A组(14.8±4.7)天、B组(23.9±6.4)天;A组并发症方面明显少于B组.差异有统计学意义(P<0.05或P<0.01);手术治疗费用A组(7 582±1 952)元、B组(3 044±1 015)元;B组在手术治疗费用方面少于A组.差异有统计学意义(P<0.05或P<0.01)。结论:后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿借助腹腔镜的放大作用.可清楚辨认肾门处的淋巴管,使淋巴管结扎更完全.具有创伤小、出血量少,术后卧床和住院时间短、无明显的并发症、恢复快、术后无复发等优点。但应严格掌握手术适应证.积极做好围手术期处理。
Objective: To evaluate the clinical value of retroperitoneal laparoscopic renal pedicle lymphatic drainage in the treatment of chyluria. Methods: The clinical data of 18 cases of chyluria (group A) and 20 cases of open group (group B) were retrospectively analyzed by retroperitoneal laparoscopic renal pedicle lymphatic drainage. Results: The operative time was 76 ± 31 in group A and 113 ± 26 in group B respectively. The bleeding volume in group A was (25 ± 29) ml and in group B was (190 ± 76) ml, The functional recovery time was 33 ± 9 h in group A, 69 ± 14 h in group B, 39 ± 8 h in group A, 74 ± 12 h in group B, Group (6.7 ± 2.5) days, group B (14.4 ± 4.1) days; group A (14.8 ± 4.7) days, group B (23.9 ± 6.4) days; group A complications were significantly less than group B. The difference was statistically significant (P0.05 or P0.01). The cost of operation treatment in group A (7 582 ± 1 952) yuan and group B (3 044 ± 1 015) yuan was less than that in group B Group, the difference was statistically significant (P <0.05 or P <0.01). Conclusion: Retroperitoneal laparoscopic renal pedicle lymphatic drainage for the treatment of chyluria by laparoscopic magnification can clearly identify the lymphatic vessels at the renal portal, the lymphatic vessel ligation more complete with less trauma, less bleeding, postoperative bed rest and Short hospital stay, no obvious complications, rapid recovery, no recurrence and so on. However, surgical indications should be strictly controlled. Positive perioperative management.