【摘要】 目的 了解行肾切除手术疾病谱、疾病的临床表现及诊治方法的演变，探讨避免肾脏切除保留肾单位的术式，以期提高对肾脏疾病的诊治水平。 方法 回顾性分析泌尿外科1955年1月－2001年12月收治入院22 603例患者的临床资料，对其中行肾切除手术的1 952例进行分析。根据肾切除手术病因，将疾病分为3类:肾肿瘤、肾结核、其他疾病。将47年分为5个时段:50、60、70、80、90年代。应用平均值、构成比、中位数、率等对各项指标进行统计学分析。 结果 5个时段年平均入院人数与年均切肾率呈上升趋势。疾病谱构成中肾肿瘤共计663例，占33.97%；肾结核共计599例，占30.69%；其他疾病共计690例，占35.35%。肾肿瘤与其他疾病的例数及构成比分别随着年代的推进不断增加。而肾结核则未显示出该特点。各年代3类疾病发病年龄（中位数）在肾肿瘤、肾结核与其他疾病亦沉陷；体检发现疾病自70年代分别为1.10%、5.10%、8.80%。 结论 90年代后，肾切除手术的术式更加标准和成熟，保留肾单位的肾脏手术正在受到临床的重视和推广。
【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