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目的了解行肾切除手术疾病谱、疾病的临床表现及诊治方法的演变,探讨避免肾脏切除保留肾单位的术式,以期提高对肾脏疾病的诊治水平。方法回顾性分析泌尿外科1955年1月-2001年12月收治入院22 603例患者的临床资料,对其中行肾切除手术的1 952例进行分析。根据肾切除手术病因,将疾病分为3类:肾肿瘤、肾结核、其他疾病。将47年分为5个时段:50、60、70、80、90年代。应用平均值、构成比、中位数、率等对各项指标进行统计学分析。结果 5个时段年平均入院人数与年均切肾率呈上升趋势。疾病谱构成中肾肿瘤共计663例,占33.97%;肾结核共计599例,占30.69%;其他疾病共计690例,占35.35%。肾肿瘤与其他疾病的例数及构成比分别随着年代的推进不断增加。而肾结核则未显示出该特点。各年代3类疾病发病年龄(中位数)在肾肿瘤、肾结核与其他疾病亦沉陷;体检发现疾病自70年代分别为1.10%、5.10%、8.80%。结论 90年代后,肾切除手术的术式更加标准和成熟,保留肾单位的肾脏手术正在受到临床的重视和推广。
Objective To understand the spectrum of disease, the clinical manifestations of the disease and the evolution of diagnosis and treatment of nephrectomy, and discuss the ways of avoiding nephrectomy in order to improve the diagnosis and treatment of kidney disease. Methods The clinical data of 22 603 patients admitted to hospital from January 1955 to December 2001 in urology were retrospectively analyzed, and 1 952 cases undergoing nephrectomy were analyzed. According to the etiology of nephrectomy, the disease is divided into three categories: kidney cancer, renal tuberculosis, other diseases. Divide 47 years into 5 time periods: 50, 60, 70, 80, 90. Application of the average, constituent ratio, median, rate of the indicators for statistical analysis. Results The average number of hospital admission and the average annual rate of renal allograft increased in 5 sessions. A total of 663 cases of nephrotic tumors were found in the disease spectrum, accounting for 33.97%. A total of 599 cases of renal tuberculosis accounted for 30.69%. A total of 690 cases accounted for 35.35% of other diseases. The number and composition of kidney tumors and other diseases are increasing with age. The renal tuberculosis did not show this feature. The age at onset of each of the three diseases (median) was also subsided in renal tumors, renal tuberculosis and other diseases. The physical examination showed that the diseases were 1.10%, 5.10% and 8.80% respectively from the 1970s. Conclusion After the 1990s, the surgical procedures of nephrectomy are more standard and mature. The nephrology of nephrons is under clinical attention and promotion.