| 周学通,郭连荣,张 青,马 丽,吴晓兵,王大伟.达芬奇机器人辅助腹腔镜下前列腺癌根治术的临床疗效及术后短期尿控恢复的影响因素分析[J].,2024,(7):1340-1344 |
| 达芬奇机器人辅助腹腔镜下前列腺癌根治术的临床疗效及术后短期尿控恢复的影响因素分析 |
| Clinical Efficacy of Da Vinci Robot Assist Laparoscopic Radical Prostatectomy and Analysis of Influencing Factors on Short-term Urinary Control Recovery after Operation |
| 投稿时间：2023-09-06 修订日期：2023-09-28 |
| DOI：10.13241/j.cnki.pmb.2024.07.027 |
| 中文关键词: 达芬奇机器人 腹腔镜下前列腺癌根治术 临床疗效 尿控恢复 影响因素 |
| 英文关键词: Da vinci robot Laparoscopic radical prostatectomy Clinical efficacy Urinary control recovery Influencing factors |
| 基金项目:国家自然科学基金项目（81972057） |
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| 中文摘要: |
| 摘要 目的：观察达芬奇机器人辅助腹腔镜下前列腺癌根治术（RALRP）的临床疗效，并分析术后尿控恢复的影响因素。方法：选取2020年3月~2023年1月期间山东第一医科大学附属省立医院收治的腹腔镜下前列腺癌根治术182例作为研究对象，根据手术方式的不同将患者分为A组（n=81，传统腹腔镜前列腺癌根治术）和B组（n=101，RALRP）。记录两组手术时间、术后1个月的尿控率、术中出血量、住院时间、尿管拔除时间、引流管拔除时间、术后并发症的发生率。针对RALRP患者，多因素Logistic回归分析术后短期尿控恢复的影响因素。结果：B组手术时间、引流管拔除时间、尿管拔除时间、住院时间短于A组，术中出血量少于A组（P<0.05）。B组术后1个月的尿控率高于A组（P<0.05）。B组的术后并发症的发生率低于A组（P<0.05）。多因素Logistic回归分析结果显示，糖尿病、经尿道前列腺电切术（TURP）史是术后尿控恢复的危险因素，而规律提肛锻炼、保留神经血管束（NVB）是术后尿控恢复的保护因素（P<0.05）。结论：RALRP治疗前列腺癌患者，可缩短手术时间、引流管拔除时间、尿管拔除时间、住院时间，减少术中出血量，同时还可提高术后1个月的尿控率，降低并发症发生率。此外，糖尿病、规律提肛锻炼、保留NVB、TURP史等均是RALRP患者术后短期尿控恢复的影响因素，值得引起重视。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the clinical efficacy of da vinci robot assist laparoscopic radical prostatectomy (RALRP), and to analyze the influencing factors of urinary control recovery after operation. Methods: 182 cases of laparoscopic radical prostatectomy who were admitted to Provincial Hospital Affiliated to Shandong First Medical University from March 2020 to January 2023 were selected as research objects, patients were divided into group A (n=81, traditional laparoscopic radical prostatectomy) and group B (n=101, RALRP) according to the different operation methods. The operation time, urinary control rate 1 month after operation, intraoperative blood loss, hospitalization time, catheter removal time, drainage tube removal time and incidence of complications after operation were recorded in two groups. For RALRP patients, the influencing factors of urinary control recovery after operation were analyzed by multivariate logistic regression analysis. Results: The operation time, drainage tube removal time, catheter removal time and hospitalization time in group B were shorter than those in group A, and the intraoperative blood loss was less than that in group A(P<0.05). The urinary control rate in group B was higher than that in group A 1 month after operation (P<0.05). The incidence of complications after operation in group B was lower than that in group A(P<0.05). Multivariate logistic regression analysis showed that, diabetes mellitus and history of transurethral resection of the prostate(TURP) were risk factors for urinary continence recovery after operation, while regular levator ani exercise and preservation of neurovascular bundle (NVB) were protective factors for urinary continence recovery after operation(P<0.05). Conclusion: RALRP in the treatment of patients with prostate cancer, which can shorten the operation time, drainage tube removal time, catheter removal time, hospitalization time, reduce intraoperative blood loss, improve the urinary control rate 1 month after operation and reduce the incidence of complications. In addition, diabetes mellitus, regular levator ani exercise, preservation of NVB and history of TURP are all influencing factors for short-term urinary continence recovery after RALRP, which is worthy of attention. |
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