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本试验旨在比较腹腔镜下肾部分切除与肾切除对小型猪肝肾功能的影响,评估手术的安全性与可行性,为两种手术方法的应用提供科学依据。试验以10头广西巴马小型猪为研究对象,随机分为腹腔镜肾部分切除术组(LPN组)与腹腔镜肾切除术组(LRN组),分别于术前、术后即刻、术后1d、2d、3d、5d、7d、14d采取前腔静脉血,检测肝功能指标丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST),肾功能指标β2微球蛋白(β2-MG)、肾损伤分子-1(KIM-1)、胱抑素C(CYS-C),比较其差异性。结果显示,两组手术均成功完成,肝、肾功能指标均呈先升高后降低趋势,与试验前相比差异极显著(P<0.01)。LPN组术后肝功能指标高于LRN组,差异极显著(P<0.01);LPN组术后肾功能指标略高于LRN组,无显著性差异(P>0.05),LPN组肾功能指标恢复至术前水平更快速。结果表明,LPN较LRN在短期内会造成更严重的肝肾损伤,但更有利于肾功能恢复,临床上应依据不同情况进行选择。
The aim of this study was to compare the effect of laparoscopic partial nephrectomy and nephrectomy on liver and kidney function in miniature pigs and to evaluate the safety and feasibility of the operation and to provide a scientific basis for the application of the two surgical methods. In this study, 10 Guangxi Bama miniature pigs were randomly divided into three groups: laparoscopic partial nephrectomy group (LPN group) and laparoscopic nephrectomy group (LRN group), respectively, before operation, immediately after operation, Anterior chamber venous blood was collected on day 1, day 2, day 3, day 5, day 7 and day 14 to detect liver function indicators such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and β2 microglobulin (β2-MG) , Kidney damage molecule-1 (KIM-1) and Cystatin C (CYS-C). The results showed that the operation of the two groups were successfully completed, liver and kidney function indicators were increased first and then decreased, compared with before the test the difference was significant (P <0.01). The postoperative LPG group was significantly higher than that of LRN group (P <0.01). The postoperative renal function index of LPN group was slightly higher than that of LRN group (P> 0.05) To the preoperative level faster. The results showed that compared with LRN, LPN can cause more severe liver and kidney injury in a short term, but it is more conducive to the recovery of renal function. Clinically, LPN should be selected according to different situations.