腹腔镜下精准解剖定位行前列腺癌或膀胱癌根治术降低术后苏醒延迟发生风险

目的 探讨腹腔镜下前列腺癌或膀胱癌根治术术后苏醒延迟的危险因素，为临床早期防治提供信息。 方法 选择2016年9月~2019年1月期间于南通市第二人民医院行腹腔镜下前列腺癌或膀胱癌根治术治疗的327例患者作为观察对象，对患者的临床资料、手术资料进行收集，统计术后苏醒延迟发生率，经Logistic回归分析法分析苏醒延迟的危险因素。 结果 腹腔镜下前列腺癌或膀胱癌根治术术后苏醒延迟检出61例，发生率是18.7%（61/327）；单因素分析发现，腹腔镜下前列腺癌或膀胱癌根治术术后苏醒延迟与患者年龄、合并冠心病、糖尿病、呼吸系统疾病、贫血及吸烟、饮酒、美国麻醉医师协会（ASA）分级、麻醉时间、术中输液总量、复合硬膜外麻醉、解剖定位标志位置清晰度和术中输血存在相关性，差异有统计学意义（P＜0.05）；多因素Logistic回归分析发现，患者年龄、合并糖尿病、伴呼吸系统疾病、贫血、吸烟、饮酒、术中输液总量和解剖定位标志位置清晰度为腹腔镜下前列腺癌或膀胱癌根治术，术后苏醒延迟的独立危险因素，差异有统计学意义（P＜0.05）。 结论 腹腔镜下前列腺癌或膀胱癌根治术,术后苏醒延迟和患者年龄、合并糖尿病、呼吸系统疾病、贫血，吸烟、饮酒、解剖定位标志位置清晰度和术中输液总量存在相关性，提示针对存在上述危险因素的患者，需给予对症干预，可以降低术后苏醒延迟发生风险。精准的解剖定位可防止术中的危险反应，利于患者术后恢复，患者对应住院时间极大地缩短。

Laparoscopic precise positioning for radical prostatectomy or bladder cancer reducing the risk of delayed recovery

Objective To analyze the risk factors of delayed recovery after laparoscopic prostate or bladder cancer radical surgery,and to provide information for early clinical prevention.Methods Three hundred and twenty-two cases of patients who underwent laparoscopic radical prostatectomy or bladder cancer surgery from September 2016 to January 2019 were enrolled in this study.The clinical data and surgical data of the patients were collected,the incidence of postoperative recovery delay was counted,and the risk factors of delayed recovery were analyzed by Logistic regression analysis.Results Six-noe cases of delayed recovery of laparoscopic prostate or bladder cancer were detected,the incidence rate was 18.7%(61/327);Univariate analysis found that delayed laparoscopic recovery of prostate or bladder cancer after radical surgery and age,combined with coronary heart disease,diabetes,respiratory disease,anemia,smoking,alcohol consumption,American Society of Anesthesiologists(ASA)classification,anesthesia time,intraoperative infusion,location clarity of anatomical landmarks were related.There was a correlation between the total amount,combined epidural anesthesia and intraoperative blood transfusion(P<0.05).Multivariate logistic regression analysis found that the age,diabetes,respiratory disease,anemia,smoking,alcohol consumption,location clarity of anatomical landmarks and intraoperative total infusion were independent risk factors for delayed recovery after laparoscopic prostate cancer or radical surgery for bladder cancer(P<0.05).Conclusion There is correlation between delayed laparoscopic recovery of prostate cancer or bladder cancer after radical operation and age,diabetes,respiratory disease,anemia,smoking,alcohol consumption,location clarity of anatomical landmarks and intraoperative total infusion.Accurate anatomical location can reduce the risk of postoperative recovery delay.It is conducive to the recovery of the patients after operation,and the corresponding hospitalization time of the patients is greatly shortened.