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

作　　者：韦发昀 蒋宁 刘华英 冯宝富 张顺[1] 丁佳蓉 甘卫东[1] 张士伟[1] 郭宏骞[1] 杨荣[1,2,3,4] WEI Fayun;JIANG Ning;LIU Huaying;FENG Baofu;ZHANG Shun;DING Jiarong;GAN Weidong;ZHANG Shiwei;GUO Hongqian;YANG Rong(Department of Urology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008;Nanjing Drum Tower Hospital Clinical College of Jiangsu University,Nanjing 210008;Department of Urology,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing 210008;Department of Urology,The Affiliated Nanjing Drum Tower Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[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

出　　处：《现代泌尿外科杂志》2024年第5期394-398,共5页Journal of Modern Urology

基　　金：国家自然科学基金项目(No.82172691)。

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。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 ofΔCRP andΔNLR[(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 

分 类 号：R737.14[医药卫生—肿瘤]