[后腹腔镜手术中的胱抑素 C 水平取决于腹腔积气和后腹腔积气模式]。

Q4 Medicine Urologiia Pub Date : 2024-09-01
S Lobanov Yu, G Shapovalov K, L Lobanov S, P Tereshkov P, S Lobanov L
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引用次数: 0

摘要

目的:研究使用腹腔镜和腹膜后入路对腹膜后内脏进行手术后患者体内胱抑素C的动态变化:对162名使用腹腔镜(83人)和腹膜后入路(79人)的肾囊肿患者的血清和尿液胱抑素C水平进行前瞻性研究。根据手术时间和气体水平,患者被分为四组。为了测定血清和尿液中的胱抑素 C 水平,使用人类肾功能面板 2 混合和匹配子面板(用于血清/血浆样本)进行了流式细胞术:结果:腹腔镜手术后第 1 天,腹腔积气压力超过 12 毫米汞柱时,无论持续时间长短,第 3 组和第 4 组血清和尿液中的胱抑素 C 水平都明显升高。至于后腹腔镜手术,只有气体压力超过 12 毫米汞柱且手术时间超过 30 分钟的第 4 组才出现类似变化。到第3天,所有组别的胱抑素C水平都恢复到基线值:结论:腹腔镜和腹膜后腔镜手术后急性肾损伤的最重要风险因素是气压。第二大重要因素是介入治疗的持续时间。与后腹腔镜手术相比,腹腔积气对胱抑素C水平的影响更大。
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[Cystatin C level during retroperitoneoscopic procedures depending on pneumoperitoneum and retro-pneumoperitoneum modes].

Aim: To study the dynamics of cystatin C in patients after procedures on retroperitoneal viscera using laparoscopic and retroperitoneal access.

Material and methods: A prospective study of serum and urine cystostatin C levels in 162 patients with renal cysts using laparoscopic (n=83) and retroperitoneal access (n=79) was carried out. Patients were divided into four groups depending on the duration of the procedure and the gas level. For determination of cystatin C level in serum and urine, flow cytometry was performed using Human Kidney Function Panel 2 Mix and Match Subpanel (for Serum/Plasma Samples).

Results: A significant increase in the serum and urine level of cystatin C in groups 3 and 4 was seen on the 1st day after laparoscopic procedures in case of pneumoperitoneum pressure above 12 mm Hg., regardless of its duration. For retroperitoneoscopic procedures, similar changes were found only in group 4 with a gas pressure above 12 mm Hg and duration of the intervention of more than 30 minutes. By day 3, cystatin C levels returned to baseline values in all groups.

Conclusion: The most significant risk factor for acute kidney injury after laparoscopic and retroperitoneoscopic procedures is the gas pressure. The second most important factor is the duration of the intervention. Pneumoperitoneum has a greater effect on cystatin C levels compared to retropneumoperitoneum.

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来源期刊
Urologiia
Urologiia Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
160
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