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目的探讨采用局部肾切除术和根治性肿瘤切除术治疗T_(1b)期肾癌患者,对其生存质量及5年生存率的影响。方法回顾性调查统计2011年1月至2014年8月收治的70例T_(1b)期肾癌患者的临床资料,按照手术方法的不同分为两组,采用局部肾切除术的患者30例为PN组,采用根治性肿瘤切除术治疗的患者40例为RN组。观察对比两组患者的术后生存质量和5年生存率。结果 PN组手术时间较RN组显著延长(P<0.01),术中出血量、术后24 h肌酐水平和术后住院时间均较RN组显著减少(P<0.05或P<0.01);PN组各项功能领域生存质量评分均较RN组显著升高(P均<0.01),前者术后并发症发生率(6.67%)较后者(10.00%)稍低,但差异无统计学意义(P>0.05);PN组术后1、2、3和5年的生存率较RN组稍低,但差异均无统计学意义(P均>0.05)。结论采用局部肾切除术治疗T_(1b)期肾癌,患者术后恢复迅速,并发症少,且生存质量显著改善,远期生存率与根治性肿瘤切除术相近。
Objective To investigate the effect of partial nephrectomy and radical tumor resection on the quality of life and the five-year survival rate of T_ (1b) stage renal cell carcinoma patients. Methods The clinical data of 70 patients with T_ (1b) stage renal cell carcinoma admitted to our hospital from January 2011 to August 2014 were retrospectively analyzed. According to the different surgical methods, the patients were divided into two groups. Thirty patients undergoing partial nephrectomy were PN group, the use of radical tumor resection in 40 patients with RN group. The postoperative quality of life and 5-year survival rate were compared between the two groups. Results The operation time of PN group was significantly longer than that of RN group (P <0.01). The intraoperative blood loss, creatinine level at 24 h after operation and postoperative hospital stay were significantly decreased compared with RN group (P <0.05 or P <0.01) The scores of quality of life in all functional areas were significantly higher than those in RN group (P <0.01). The former had a lower incidence of postoperative complications (6.67%) than the latter (10.00%), but the difference was not statistically significant (P > 0.05). The survival rates at 1, 2, 3 and 5 years postoperatively in PN group were slightly lower than those in RN group, but the differences were not statistically significant (all P> 0.05). Conclusion The treatment of T_ (1b) stage renal cell carcinoma with partial nephrectomy is rapid, the complication is less, the quality of life is significantly improved, and the long-term survival rate is similar to that of radical tumor resection.