临床外科杂志 ›› 2025, Vol. 33 ›› Issue (4): 425-428.doi: 10.3969/j.issn.1005-6483.20240923

• 论著 • 上一篇    下一篇

腹腔镜肾部分切除术病人糖脂代谢、Mayo粘连概率评分与肾周脂肪粘连及预后关系

曹振虎,刘龙强   

  1. 716000 陕西省延安市人民医院泌尿外科
  • 收稿日期:2024-06-12 出版日期:2025-04-20 发布日期:2025-04-20
  • 通讯作者: 刘龙强，Email:miwaiyi126.com
  • 基金资助:
    陕西省延安市重点研发计划项目(2023SLSFGG-014)

Relationship between glucose and lipid metabolism,MAP score,perirenal fat adhesion and surgical efficacy in patients undergoing laparoscopic partial nephrectomy

CAO Zhenhu,LIU Longqiang   

  1. Department of Urology,Yan’an People’s Hospital,Shaanxi,Yan’an 716000,China
  • Received:2024-06-12 Online:2025-04-20 Published:2025-04-20

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摘要： 目的 探讨腹腔镜肾部分切除术病人糖脂代谢、Mayo粘连概率(MAP)评分与肾周脂肪粘连及预后的关系。方法 2019年12月～2022年12月行腹腔镜肾部分切除术病人84例，根据术中是否发生肾周脂肪粘连(APF)将病人分为APF组(44例)和非APF组(40例)；术后1年随访结果肿瘤是否复发分为预后良好组（68例）和预后不良组（16例）。术前记录病人性别、年龄、体重指数(BMI)、空腹血糖(FPG)、血清甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和MAP评分。采用受试者工作特征曲线(ROC)分析糖脂代谢和MAP评分对APF的评估价值，采用多因素Logistic回归分析 LPN预后的影响因素。结果 APF组和非APF组病人的性别、年龄、BMI、FPG、TG、HDL-C和MAP评分比较差异均有统计学意义(P<0.05)；ROC曲线分析显示，FPG、TG、HDL-C和MAP评分APF有一定的评估价值，且四者联合评估的整体效能更好；预后良好组和预后不良组病人的性别、年龄、BMI、APF、FPG、TG、HDL-C、MAP评分和APF差异有统计学意义(P<0.05)；多因素Logistic回归分析结果显示，FPG、TG、HDL-C和MAP评分均为LPN预后不良的危险因素。结论 FPG、TG、HDL-C和MAP评分对APF有一定的评估价值，具有较高的灵敏度和特异度，四者联合评估的整体效能更好；FPG、TG、HDL-C和MAP评分均为LPN预后不良的危险因素。

关键词: 腹腔镜肾部分切除术, 糖脂代谢, MAP评分, 肾周脂肪粘连, 预后

Abstract: Objective To investigate the glucose and lipid metabolism,Mayo adhesion probability (MAP) score and perirenal function in patients with laparoscopic partial nephrectomy The relationship between fat adhesion and prognosis.Methods A total of 84 patients who underwent laparoscopic resection in our hospital from December 2019 to December 2022 were retrospectively selected as the research subjects.According to whether perirenal fatty adhesion (APF) occurred during the operation,the patients were divided into APF group (44 cases) and non-APF group (40 cases).The results of 1-year follow-up were divided into good prognosis group (68 cases) and poor prognosis group (16 cases) The patient’s gender,age,body mass index (BMI),fasting blood glucose (FPG),serum triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and MAP score were recorded before surgery.All patients underwent laparoscopic partial nephrectomy,and the receiver operating curve (ROC) was used to analyze the evaluation value of glucose and lipid metabolism and MAP score for APF.Multivariate Logistic regression was used to analyze the influencing factors of LPN.Results There were statistically significant differences in gender,age,BMI,APF,FPG,TG,HDL-C and MAP scores between the APF group and the non-APF group (P<0.05);ROC curve analysis showed that FPG,TG,HDL-C and MAP Scoring APF has certain evaluation value,and the overall performance of the combined evaluation of the four was better.There were significant differences in gender,age,BMI,FPG,TG,HDL-C and MAP scores between the good prognosis group and the poor prognosis group (P<0.05).Multivariate Logistic regression analysis showed that FPG,TG,HDL-C and MAP scores,APF were all risk factors for ineffective LPN surgery.Conclusion FPG,TG,HDL-C and MAP scores have a certain value for APF evaluation,with high sensitivity and specificity,and the overall efficiency of the combined evaluation is better.FPG,TG,HDL-C and MAP scores were all risk factors for ineffective LPN surgery.

Key words: laparoscopic partial nephrectomy, glucose and lipid metabolism, MAP score, perirenal fat adhesion, surgical efficacy

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