腹腔镜下行去顶开窗术治疗多囊肾合并多囊肝临床价值并文献复习

doi:10.3969/j.issn.1672-5069.2014.06.017

实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (6): 628-632.doi: 10.3969/j.issn.1672-5069.2014.06.017

腹腔镜下行去顶开窗术治疗多囊肾合并多囊肝临床价值并文献复习

李海波, 李超志, 沈群山, 梁宇, 冯鹏程, 孟杰, 程红涛, 张珺

230031 合肥市解放军第105医院泌尿外科

收稿日期:2014-07-30 出版日期:2014-12-31 发布日期:2016-04-11
通讯作者: 李超志,E-mail：sqsforever@foxmail.com
作者简介:李海波,男,38岁,医学硕士,副教授,副主任医师。主要从事泌尿外科微创治疗研究。E-mail：lihaibo105 @sina.cn

Fenestration for polycystic kidney complicated with polycystic liver under laparoscopy and literature review

Li Haibo, Li Chaozhi, Shen Qunshan

Department of Urology,105th Hospital of People's Liberation Army,Hefei 230031,Anhui Province,China

Received:2014-07-30 Online:2014-12-31 Published:2016-04-11

摘要/Abstract

摘要： 目的探讨在腹腔镜下行去顶开窗术治疗多囊肾合并多囊肝患者的临床应用价值并文献复习。方法回顾性分析我院 2009 年 1 月~2014 年 2 月收治的 8 例多囊肾合并多囊肝患者的临床资料,8 例患者均行腹腔镜下肝、肾囊肿去顶开窗术治疗。结果8 例患者均在腹腔镜下完成肝、肾囊肿去顶开窗术,手术顺利,无1例中转开放;手术时间为 70~120 min,平均（96.31±14.26） min;无并发症发生;住院时间为4~6 d,平均（4.89±0.76） d;术后随访时间为8~24 m,平均随访（18.52±5.03） m;8 例患者腰腹部胀痛程度和高血压均降低,5 例患者血肌酐、尿素氮、胱抑素 C 明显降低,3 例患者肾功能无明显改善。结论在腹腔镜下行多囊肾合并多囊肝去顶开窗术具有创伤小、住院时间短、临床症状改善明显等优点,值得在临床推广应用。

关键词: 多囊肾, 多囊肝, 腹腔镜下去顶开窗术, 疗效

Abstract: Objective To evaluate the clinical value of laparoscopic fenestration for polycystic kidney complicated with polycystic liver. Methods The data of eight patients who received laparoscopic fenestration for polycystic kidney complicated with polycystic liver during January 2009 and February 2014 were collected and retrospectively analyzed. Results The procedures were successfully performed in all 8 cases,and no cases was conversed to open abdominal operation. The mean operating time was （96.31±14.26） min （70 to 120 min） without complications. The mean hospital stay were（4.89±0.76） days （4 to 6 days）. The average followed-up period after operation were（18.52±5.03） months（8 to 24 months）. The symptom of abdominal pain was improved and high blood pressure decreased in all 8 cases. The serum creatinine,blood urea nitrogen and cystatin C levels were significantly decreased in 5 cases,while in 3 cases had no significant improvement in renal function. ConclusionsThe laparoscopic fenestration for polycystic kidney complicated with polycystic liver has advantages of less injury,shorter hospital stay and significantly improved clinical symptoms, which may worth the clinical application.

Key words: Polycystic kidney, Polycystic liver, Laparoscopic fenestration, Efficacy

李海波, 李超志, 沈群山, 梁宇, 冯鹏程, 孟杰, 程红涛, 张珺. 腹腔镜下行去顶开窗术治疗多囊肾合并多囊肝临床价值并文献复习[J]. 实用肝脏病杂志, 2014, 17(6): 628-632.

Li Haibo, Li Chaozhi, Shen Qunshan. Fenestration for polycystic kidney complicated with polycystic liver under laparoscopy and literature review[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(6): 628-632.

参考文献

[1] Abu-wasel B,Walsh C,Keough V,et al. Pathophysiology, epidemiology,classification and treatment options for polycystic liver diseases. World J Gastroenterol,2013,19（35）:5775-5786.
[2] Chandok N. Polycystic liver disease:a clinical review. Ann Hepatol,2012,11（6）:819-826.
[3] Torres VE,Harris PC,Pirson Y. Autosomal dominant polycystic kidney disease. Lancet,2007,369（9569）:1287-1301.
[4] Hogan MC,Masyuk TV,Page LJ,et al. Randomized clinical trial of long-acting somatostatin for autosomal dominant polycystic kidney and liver disease. J Am Soc Nephrol,2010,21（6）:1052-1061.
[5] Temmerman F,Missiaen L,Bammens B,et al. Systematic review: the pathophysiology and management of polycystic liver disease. Aliment Pharmacol Therapeut,2011,34（7）:702-713.
[6] Qian Q. Isolated polycystic liver disease. Adv Chron Kid Dis, 2010,17（2）:181-189.
[7] Peces R,González P,Venegas J. Enfermedad poliquística hepática no asociada a poliquistosis renal autosómica dominante. Nefrología,2003,23（5）:454-458.
[8] Lazaridis KN,Strazzabosco M,Larusso NF. The cholangiopathies: Disorders of biliary epithelia. Gastroenterology,2004,127（5）: 1565-1577.
[9] de la Piscina PR,Duca I,Estrada S,et al. Combined liver and kidney transplant in a patient with Budd-Chiari syndrome secondary to autosomal dominant polycystic kidney disease associated with polycystic liver disease:Report of a case with a 9-year follow-up. Gastrointestinal Med,2014,doi:10.1155/2014/585291.
[10] Everson GT. Polycystic liver disease. Gastroenterol Hepatol, 2008,4（3）:179-181.
[11] Albandea moreno C,Aguilar urbano V,Fernández Pérez F, et al. Enfermedad poliquística hepática. Revista Espanola De Enfermedades Digestivas,2009,101（7）:495-497.
[12] Masoumi A,Reed-gitomer B,Kelleher C,et al. Developments in the management of autosomal dominant polycystic kidney disease. Therapeut Clin Risk Manag,2008,4（2）:393-407.
[13] Wilson SJ,Amsler K,Hyink DP,et al. Inhibition of Her-2 （neu/erbb2） restores normal function and structure to polycystic kidney disease（pkd） epithelia. Biochimica Et Biophysica Acta, 2006,1762（7）:647-655.
[14] Berthier CC,Wahl PR,Le hir M,et al. Sirolimus ameliorates the enhanced expression of metalloproteinases in a rat model of autosomal dominant polycystic kidney disease. Nephrol Dialysis Transplant,2008,23（3）:880-889.
[15] Walz G,Budde K,Mannaa M,et al. Everolimus in patients with autosomal dominant polycystic kidney disease. New Engl J Med,2010,363（9）:830-840.
[16] Renken C,Fischer D,Kundt G,et al. Inhibition of mtor with sirolimus does not attenuate progression of liver and kidney disease in Pck rats. Nephrol Dialys Transplant,2011,26（1）:92-100.
[17] Caroli A,Antiga L,Cafaro M,et al. Reducing polycystic liver volume in adpkd:Effects of somatostatin analogue octreotide. Clin J Am Soc Nephrol,2010,5（5）:783-789.
[18] Gevers TJ,Drenth JP. Somatostatin analogues for treatment of polycystic liver disease. Curr Opin Gastroenterol,2011,27（3）: 294-300.
[19] 林建军,金昌男,林圣远. 超声介入治疗非寄生虫性肝囊肿32例. 实用肝脏病杂志,2005,8（2）:96-97.
[20] 朱龙柏. 肝囊肿经腹腔镜开窗引流治疗的临床效果观察. 中国医药指南,2013,11（8）:591-592.
[21] Torres VE,Rastogi S,King BF,et al. Hepatic venous outflow obstruction in autosomal dominant polycystic kidney disease. J Am Soc Nephrol,1994,5（5）:1186-1192.

腹腔镜下行去顶开窗术治疗多囊肾合并多囊肝临床价值并文献复习

Fenestration for polycystic kidney complicated with polycystic liver under laparoscopy and literature review

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	朱娅鸽, 刘锦峰. 丁二磺酸腺苷蛋氨酸联合复方甘草酸苷治疗酒精性肝硬化患者疗效及其对血清BGP水平的影响^*[J]. 实用肝脏病杂志, 2019, 22(6): 872-875.
[2]	巴正武, 栗海龙, 杨慧. 能谱CT成像定量评估Budd-Chiari综合征患者TIPS术治疗前后肝功能状态临床价值研究*[J]. 实用肝脏病杂志, 2019, 22(5): 680-683.
[3]	张志成, 袁广庆, 莫灿均. 肝动脉栓塞术治疗三种类型肝血管瘤患者疗效及安全性分析*[J]. 实用肝脏病杂志, 2019, 22(5): 736-739.
[4]	白一春, 邓霁红, 梅小平. 影响聚乙二醇干扰素α-2b治疗慢性乙型肝炎患者疗效的多因素分析^*[J]. 实用肝脏病杂志, 2019, 22(4): 490-493.
[5]	严玲玲, 胡东辉, 黄艳芳. 腺苷蛋氨酸联合多烯磷酯酰胆碱治疗妊娠期肝内胆汁淤积症患者临床疗效初步研究^*[J]. 实用肝脏病杂志, 2019, 22(4): 530-533.
[6]	王宝丹, 李萌, 高于. α-干扰素治疗慢性乙型肝炎儿童疗效及其影响疗效的因素分析[J]. 实用肝脏病杂志, 2019, 22(3): 345-348.
[7]	袁春晖, 李春雨, 李红丽, 赵红娜, 王文红, 孟庆旭, 张中学. 国产聚乙二醇化干扰素α治疗HBeAg阳性慢性乙型肝炎患者疗效研究[J]. 实用肝脏病杂志, 2019, 22(3): 353-356.
[8]	徐曼曼, 陈煜, 李爽. 特利加压素联合白蛋白输注治疗肝肾综合征患者疗效及尿NGAL和KIM-1对疗效的预测价值[J]. 实用肝脏病杂志, 2019, 22(3): 385-388.
[9]	王秀清,马艳君,詹晋莉. 肝动脉化疗栓塞术联合超声引导下微波消融术治疗特殊部位原发性肝癌患者疗效及安全性分析 ^*[J]. 实用肝脏病杂志, 2019, 22(2): 260-263.
[10]	赵鹏, 王磊. 聚乙二醇化干扰素-α对不同基因型慢性丙型肝炎患者治疗效果比较^*[J]. 实用肝脏病杂志, 2019, 22(1): 57-60.
[11]	闫焕杰, 张淑芹, 赵文静. 自体骨髓干细胞移植治疗慢加急性乙型肝炎肝衰竭患者疗效初步研究[J]. 实用肝脏病杂志, 2019, 22(1): 81-84.
[12]	曹艳平, 隋洪婷, 潘猛, 曲宝聚, 朴红心. 恩替卡韦联合聚乙二醇干扰素或胸腺素治疗代偿期乙型肝炎肝硬化2年疗效随访^*[J]. 实用肝脏病杂志, 2019, 22(1): 93-96.
[13]	王禅, 秦伟, 戴勇, 李晓峰, 张成强. 自体外周血干细胞移植治疗乙型肝炎肝硬化患者临床疗效及其对外周血T淋巴细胞亚群的影响[J]. 实用肝脏病杂志, 2019, 22(1): 97-100.
[14]	马履翔, 张雪松. 超声引导下经皮射频消融治疗小肝癌患者疗效及预后分析^*[J]. 实用肝脏病杂志, 2019, 22(1): 125-128.
[15]	黄娇凤, 林苏, 王明芳, 黄映芳, 熊美连, 朱月永. 恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病患者疗效及其对肝组织脂肪变的影响^*[J]. 实用肝脏病杂志, 2018, 21(6): 863-867.