现代泌尿外科杂志2024,Vol.29Issue(5) :394-398.DOI:10.3969/j.issn.1009-8291.2024.05.003

普芦卡必利在机器人辅助腹腔镜根治性膀胱切除+尿流改道术围手术期应用的效果分析

Perioperative application of prucalopride in robot-assisted laparoscopic radical cystectomy and urinary diversion

韦发昀 蒋宁 刘华英 冯宝富 张顺 丁佳蓉 甘卫东 张士伟 郭宏骞 杨荣
现代泌尿外科杂志2024,Vol.29Issue(5) :394-398.DOI:10.3969/j.issn.1009-8291.2024.05.003

普芦卡必利在机器人辅助腹腔镜根治性膀胱切除+尿流改道术围手术期应用的效果分析

Perioperative application of prucalopride in robot-assisted laparoscopic radical cystectomy and urinary diversion

韦发昀 1蒋宁 2刘华英 3冯宝富 4张顺 1丁佳蓉 1甘卫东 1张士伟 1郭宏骞 1杨荣5
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作者信息

  • 1. 南京大学医学院附属鼓楼医院泌尿外科,江苏南京 210008
  • 2. 江苏大学鼓楼临床医学院,江苏南京 210008
  • 3. 南京中医药大学附属鼓楼医院泌尿外科,江苏南京 210008
  • 4. 南京医科大学附属鼓楼医院泌尿外科,江苏南京 210008
  • 5. 南京大学医学院附属鼓楼医院泌尿外科,江苏南京 210008;江苏大学鼓楼临床医学院,江苏南京 210008;南京中医药大学附属鼓楼医院泌尿外科,江苏南京 210008;南京医科大学附属鼓楼医院泌尿外科,江苏南京 210008
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摘要

目的 明确普芦卡必利(PRUC)在机器人辅助腹腔镜根治性膀胱切除(RARC)+尿流改道术围手术期对患者肠道功能的影响.方法 回顾性分析2021年4-12月南京大学医学院附属鼓楼医院收治的75例行RARC+尿流改道术(原位膀胱术/回肠膀胱术)患者,根据围手术期是否服用PRUC分为PRUC组(28例)和常规组(47例).分析比较两组患者术后肠道通气时间、通便时间、引流管留置时间、首次进食半流食物耐受时间、术后住院时间以及术后并发症的发生率,并比较两组患者术后C反应蛋白(CRP)和中性粒细胞/淋巴细胞比值(NLR)的变化.结果 PRUC组较常规组患者肠道通气时间和通便时间均更短[(47.14±16.31)h vs.(74.04±35.33)h,P<0.01;(86.14±30.47)h vs.(123.57±79.12)h,P=0.02].PRUC 组较常规组术后 CRP(ΔCRP)和 NLR 变化幅度(ΔNLR)均较小[(79.99±29.71)mg/L vs.(127.75±56.98)mg/L;(9.24±6.43)vs.(16.11±9.90),P均<0.01].所有并发症均为次要并发症,PRUC组患者术后90 d内肠梗阻发生率有降低的趋势(P=0.38),两组间其他并发症差异均无统计学意义(P>0.05).结论 PRUC可促进RARC+尿流改道术患者术后肠道功能恢复.

Abstract

Objective To explore the effects of prucalopride(PRUC)on the intestinal function during the perioperative period of robot-assisted laparoscopic radical cystectomy(RARC)and urinary diversion.Methods A total of 75 patients undertaking RARC with urinary diversion(orthotopic neobladder or ileal bladder)in Nanjing Drum Hospital during Jan.and Dec.2021 were divided into PRUC group(n=28)and control group(n=47)according to whether they took PRUC or not.Postoperative intestinal ventilation time and defecation time,drainage tube retention time,tolerance time for first intake of semi-flow food,postoperative hospital stay,and incidence of complications were observed and recorded in the two groups.Postoperative C-reactive protein(CRP)and neutrophil/lymphocyte ratio(NLR)were compared.Results The PRUC group had shorter intestinal ventilation time and defecation time[(47.14±16.31)h vs.(74.04±35.33)h,P<0.01;(86.14±30.47)h vs.(123.57±79.12)h,P=0.02],smaller change of ΔCRP and ΔNLR[(79.99±29.71)mg/L vs.(127.75±56.98)mg/L;(9.24±6.43)vs.(16.11±9.90),P<0.01].All complications were minor,the incidence of intestinal obstruction in PRUC group tended to decrease within 90 days after operation(P=0.38),and there was no significant difference in other complications between the two groups(P>0.05).Conclusion The perioperative use of PRUC in RARC with urinary diversion is safe and effective,which can promote the recovery of intestinal function after operation.

关键词

膀胱癌/机器人辅助腹腔镜根治性膀胱切除/尿流改道/普芦卡必利/术后肠梗阻/肠道功能/围手术期

Key words

bladder cancer/robot-assisted laparoscopic radical cystectomy/urinary diversion/prucalopride/post-operative ileus/intestinal function/perioperative period

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基金项目

国家自然科学基金(82172691)

出版年

2024
现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
参考文献量22
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