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中华腔镜泌尿外科杂志(电子版) ›› 2017, Vol. 11 ›› Issue (05) : 289 -294. doi: 10.3877/cma.j.issn.1674-3253.2017.05.001

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临床研究

肾上腺肿瘤评分系统的创立
张磊1, 胡卫列1,()   
  1. 1. 510010 广州军区广州总医院泌尿外科
  • 收稿日期:2017-01-15 出版日期:2017-10-01
  • 通信作者: 胡卫列
  • 基金资助:
    2015广州市科技计划一般项目(201510010242); 2015省自然博时启动项目(2015A030310474); 2016博士后基金面上项目(2016M602449); 国家自然科学基金青年科学基金项目(81302230)

The establishment of a score system for adrenal tumors

Lei Zhang1, Weilie Hu1,()   

  1. 1. Department of Urology, Guangzhou General Hospital of Gwuangzhou Military Command of Popte's Liberation Army of China, Guangzhou 510010, China
  • Received:2017-01-15 Published:2017-10-01
  • Corresponding author: Weilie Hu
  • About author:
    Corresponding author: Hu Weilie,Email:
引用本文:

张磊, 胡卫列. 肾上腺肿瘤评分系统的创立[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(05): 289-294.

Lei Zhang, Weilie Hu. The establishment of a score system for adrenal tumors[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(05): 289-294.

目的

创建肾上腺肿瘤评分系统,评估肾上腺肿瘤手术的难度和复杂性。

方法

回顾单中心同一术者实施后腹腔镜肾上腺肿瘤手术的466例患者临床资料,对肿瘤的大小、与周围器官的边界、与腹腔大血管的边界、内分泌功能及体质量指数(BMI)进行量化,通过分析各因素与手术时间、术中出血量的相关性,筛选出具有相关性的指标创建肾上腺肿瘤评分(ATS)系统,并对该评分系统进行临床验证。

结果

肿瘤的大小、周围器官的边界、腹腔大血管的边界、内分泌功能、BMI与手术时间、术中出血量均有相关性(P<0.01)。ATS与手术时间、术中出血量均有相关性(P<0.01),高、中、低复杂性评分组间的手术时间、术中出血量差异均有显著统计学意义(P<0.05)。

结论

肾上腺肿瘤评分系统涵盖了影响肾上腺肿瘤手术的难度和复杂性的主要因素,对于术前评估具有重要的临床指导价值。

Objective

To found a score system to estimate operation difficulty and surgical complexity of adrenal tumors.

Methods

A retrospective single-center analysis was made in 466 patierts with adrenal tumors who underwent retroperitoneal laparoscopic surgery by the same surgeon. The adrenal tumor score system (ATS) was based on the quantization of the following independent variables: size of the tumors, boundary with surrounding organs, boundary with abdominal great vessels, endocrine function and body mass index, which were associated with operation time and the amount of bleeding after screening, and a clinical validation was performed for the score system.

Results

By univariate and multivariate Logistic regression analysis in 466 cases of adrenal tumor, size of the tumors, boundary with surrounding organs, boundary with abdominal great vessels, endocrine function and body mass index were all associated with operation time and the amount of bleeding (P<0.01). A correlation existed between ATS and operation time, blood loss during operation (P<0.01). And there were significant differences among high, moderate and low complexity groups.

Conclusion

ATS system covering all the major factors that influence operation difficulty and surgical complexity of adrenal tumors, has important clinical value of surgical treatment.

图6b 右肾上腺肿瘤压迫下腔静脉(冠状面)
表1 各因素对手术时间的单因素线性回归分析
表2 各因素对手术时间的多元线性回归分析
表3 各因素对术中出血量的单因素线性回归分析
表4 各因素对术中出血量的多元线性回归分析
图7 ATS评分与手术时间的散点图
图8 ATS评分与术中出血量的散点图
表5 肾上腺肿瘤评分(ATS)系统的量化评分
表6 不同评分组的手术时间、出血量比较分析结果(±s
表7 不同ATS评分组的手术并发症[例(%)]
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