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目的:探讨PADUA评分系统在保留肾单位手术(NSS)中与手术时间、热缺血时间、并发症等相关因素的关系。方法:回顾性分析127例次行NSS的124例肾肿瘤患者的临床资料,行PADUA评分,并利用χ2检验、Fisher确切检验等分析PADUA评分与手术时间、热缺血时间、并发症、出血量、术后住院时间、术后第1天血肌酐变化率的关系。结果:PADUA评分低、中、高度复杂肿瘤分别为40例、62例、25例,LNSS组手术时间与PADUA评分有关(P=0.012),ONSS组只有高度与低度复杂肿瘤之间有统计学意义(P=0.005)。对于低度复杂肿瘤,LNSS比ONSS手术时间短(P=0.009)。PADUA评分与热缺血时间相关,与围手术期并发症、术后第1天血肌酐变化率无关。ONSS组出血量与PADUA评分无关,而LNSS组两者有关(P=0.031)。LNSS组高度比低度复杂肿瘤术后住院时间长。结论:PADUA评分与NSS手术时间、热缺血时间等相关因素密切相关,可以预测手术相关结果,指导肾肿瘤的治疗。
Objective: To investigate the relationship between the PADUA score system and the related factors such as operative time, warm ischemia time and complications during the nephron sparing surgery (NSS). Methods: The clinical data of 124 patients with renal tumor who underwent NSS were retrospectively analyzed. The PADUA score was used. The PADUA score was compared with the operation time, warm ischemia time, complications, bleeding volume , Postoperative hospital stay, the rate of change of serum creatinine on the first postoperative day. Results: There were 40 cases with low, medium and high complexity tumors in PADUA score, 62 cases in 25 cases, and 25 cases in LNSS group. The operation time was related to PADUA score (P = 0.012) in the LNSS group. There was statistical difference between the ONSS group and the complicated tumors Meaning (P = 0.005). For low-grade tumors, LNSS was shorter than ONSS (P = 0.009). The PADUA score correlated with the time of warm ischemia and was not related to the perioperative complications and the rate of change of serum creatinine on the first day after operation. The bleeding volume in ONSS group was not related to PADUA score, but was related to LNSS group (P = 0.031). The LNSS group had a longer postoperative hospital stay than those with less complex tumors. Conclusion: The PADUA score is closely related to the operative time of NSS, the duration of warm ischemia and other related factors. It can predict the results of surgery and guide the treatment of renal tumors.