【摘要】 目的 了解行腎切除手術疾病譜、疾病的臨床表現及診治方法的演變，探討避免腎臟切除保留腎單位的術式，以期提高對腎臟疾病的診治水平。 方法 回顧性分析泌尿外科1955年1月－2001年12月收治入院22 603例患者的臨床資料，對其中行腎切除手術的1 952例進行分析。根據腎切除手術病因，將疾病分為3類:腎腫瘤、腎結核、其他疾病。將47年分為5個時段:50、60、70、80、90年代。應用平均值、構成比、中位數、率等對各項指標進行統計學分析。 結果 5個時段年平均入院人數與年均切腎率呈上升趨勢。疾病譜構成中腎腫瘤共計663例，占33.97%；腎結核共計599例，占30.69%；其他疾病共計690例，占35.35%。腎腫瘤與其他疾病的例數及構成比分別隨著年代的推進不斷增加。而腎結核則未顯示出該特點。各年代3類疾病發病年齡（中位數）在腎腫瘤、腎結核與其他疾病亦沉陷；體檢發現疾病自70年代分別為1.10%、5.10%、8.80%。 結論 90年代后，腎切除手術的術式更加標準和成熟，保留腎單位的腎臟手術正在受到臨床的重視和推廣。
【Abstract】 Objective To study the spectrum of diseases subjected to nephrectomy, to find out the clinical manifestations of the diseases, to summarize the evolvement of operational technology of kindney removal, to discuss the method of nephron sparing surgery in the purpose of avoiding nephrectmoy and reducing the operational risk, and to promote the level of diagnosing and treating nephropathy. Methods There were 1 952 cases of nephrectomy selected in the total 22 603 cases treated in the Department of Urology from January 1955 to December 2001. According to the diseases subjected to the surgery, these 1 952 cases were assigned into 3 groups: renal tumor group, renal tuberculosis group and other diseases group. The 47 years from 1955 to 2001 were divided into 5 periods: the 1950s (1955-1960), 60s (1961-1970), 70s (1971-1980), 80s (1981-1990) and 90s (1991-2001). Indexes such as average, proportion, median, and ratio were analyzed statistically. Results From the 1950s to 1990s, the number of patients undergoing nephrectomy increased from period to period. Among the diseases causing the surgery, the number of renal tumor cases was 663 (33.97%), the number of renal tuberculosis cases was 599 (30.69%), and the number of other disease cases was 690 (35.35%). The number and proportion of renal tumor and other disease cases increased from year to year, while the nuber of renal tuberculosis cases did not show this feature. The median age of patients treated with nephrectomy increased year by year, and the patient’s age of renal tumor was older than that of renal tuberculosis and other diseases. The proportion of patients whose diseases were found out by physical examination since the 1970s was respectively 1.10%, 5.10% and 8.80%. Conclusion Since the 1990s, the technology of nephrectomy has become maturer and more standardized, and nephron sparing surgery has caught more attention and has been applied more in clinics.
Citation： DOU Ke,LU Yiping,LI Xiang,DONG Qiang,WANG Kunjie. Retrospective Analysis of Nephrectomy Cases during the Past 47 Years in West China Hospital of Sichuan University. West China Medical Journal, 2011, 26(8): 1174-1177. doi: Copy
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