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目的 评价穿刺硬化、腹腔镜及开放手术治疗肾囊性病变的临床价值。方法 对 10 5例穿刺硬化、38例腹腔镜、15例开放手术治疗肾囊性病变的临床资料进行回顾性分析。结果 三组手术均获成功。手术费用分别为 2 0 0～ 30 0元、5 5 0 0～ 6 5 0 0元和 4 0 0 0～ 5 0 0 0元 ;手术时间分别为 2 0～ 35min、80～ 180min和 6 0～ 90min ;术中平均出血量分别为 0ml、10～ 2 0ml和 10 0～ 2 0 0ml;术后住院天数为 0d、5～ 7d和 8～ 12d。穿刺组无并发症。腹腔镜组有 1例较大囊肿漏诊 ,1例伴PUJ狭窄再行开放手术。开放组术后 1例尿漏者经置双J内支架管治愈。穿刺组 2年内需再次治疗者占 8例 (7.6 % ) ,腹腔镜及开放组无复发病例。结论 三种治疗方式各有其优缺点 ,应根据患者的具体情况来选择
Objective To evaluate the clinical value of puncture sclerosis, laparoscopy and open surgery in the treatment of renal cystic lesions. Methods The clinical data of 105 cases with puncture sclerosis, 38 cases of laparoscopy and 15 cases of open surgery for renal cystic lesions were analyzed retrospectively. Results All the three surgeries were successful. The cost of operation was 200 ~ 30 0 yuan, 5500 ~ 6500 yuan and 40000 ~ 5000 yuan respectively. The operative time was 20 ~ 35 minutes, 80 ~ 180 minutes and 60 ~ 90min. The mean intraoperative blood loss was 0ml, 10 ~ 20ml and 100 ~ 200ml, respectively. The days of hospitalization were 0d, 5 ~ 7d and 8 ~ 12d. Puncture group without complications. One case of laparoscopic group missed diagnosis of larger cysts, one case of reopening open surgery with PUJ stenosis. One case of urinary drain in open group was treated with double J stent. Puncture group required re-treatment within 2 years accounted for 8 cases (7.6%), laparoscopy and open group without recurrence. Conclusion The three kinds of treatment have their own advantages and disadvantages, should be based on the specific circumstances of patients to choose