目的：探讨机器人辅助腹腔镜前列腺癌根治术（RARP）后患者麻醉复苏期发生低氧血症的危险因素。 方法：选取 2023 年 7 月—2023 年 12 月于南京医科大学第一附属医院行 RARP 的 88 例患者为研究对象，根据患者 术后进入麻醉恢复室（PACU）后是否出现低氧血症分为发生组（n=31）、未发生组（n=57）。收集两组患者一般资料、 病情相关资料、手术相关资料并进行比较。采用 Logistic 回归进行单因素、多因素分析探讨 RARP 术后患者麻醉复 苏期发生低氧血症的危险因素。结果：一般资料比较，两组患者在年龄、手术时间、术前新辅助治疗、术中输血及 术后体温方面存在显著差异（P<0.05）。单因素 Logistic 回归分析显示，年龄、术前新辅助治疗、手术时间、术中输血、 术后体温均为 RARP 术后患者麻醉复苏期低氧血症发生的相关影响因素（P<0.05）。多因素 Logistic 回归分析显示， 术中输血、术后体温 <36℃是 RARP 术后患者麻醉复苏期低氧血症发生的独立危险因素（P<0.05）。两独立危险因 素联合预测RARP术后患者麻醉复苏期低氧血症发生曲线下面积为0.697，标准错误为0.063，置信区间为0.574~0.821， 特异度为 0.912，敏感度为 0.584，有一定临床参考价值（P<0.05）。结论：术中输血、术后体温 <36℃是 RARP 术 后患者麻醉复苏期低氧血症发生的独立危险因素。

Objective: To investigate the risk factors to hypoxemia in patients recovering from anesthesia after robotassisted laparoscopic radical prostatectomy (RARP). Methods: 88 patients who underwent RARP in the first Hospital with Nanjing Medical University from July 2023 to December 2023 were selected, they were divided into the hypoxemia-occurrence group (n=31) and the nonoccurrence group (n=57) according to whether hypoxemia occurred or not after entering the postanesthesia care unit (PACU). General data, conditions and surgical data of patients in the two groups were collected and compared. Univariate and multivariate Logistic regression analyses were performed to analyze risk factors of hypoxemia in patients after RARP. Results: By analyzing general data of the two groups of patients who underwent RARP, it was found that there were significant differences in age, surgical time, preoperative neoadjuvant therapy, intraoperative blood transfusion, and postoperative body temperature between the two groups (P<0.05). Univariate Logistic regression analysis showed that age, preoperative neoadjuvant therapy, operative time, intraoperative blood transfusion, and postoperative body temperature were all influencing factors to the occurrence of hypoxemia in patients recovering from anesthesia after RARP (P<0.05). Multivariate Logistic regression analysis showed that intraoperative blood transfusion and postoperative body temperature <36℃ were independent risk factors for hypoxemia in patients recovering from anesthesia after RARP (P<0.05). The joint prediction of the above two independent risk factors for the occurrence of hypoxemia in patients underwent RARP during recovery from anesthesia has an area under the curve of 0.697, a standard error of 0.063, a confidence interval of 0.574 to 0.821, a specificity of 0.912, a sensitivity of 0.584, which had certain reference value (P<0.05). Conclusion: Intraoperative blood transfusion and postoperative temperature <36℃ are independent risk factors for the occurrence of hypoxemia during recovery from anesthesia in patients who underwent RARP.

收稿日期：2024-03-26  录用日期：2024-04-12 

Received Date: 2024-03-26  Accepted Date: 2024-04-12 

基金项目：江苏省人民医院临床能力提升工程护理项目（JSPH-NC-2021-23） 

Foundation Item: Nursing Program of Clinical Ability Enhancement Project of Jiangsu Provincial People’s Hospital (JSPHNC-2021-23) 

通讯作者：黄美华，Email：1934259844@qq.com 

Corresponding Author: HUANG Meihua, Email: 1934259844@qq.com 

引用格式：尹瑞，刘双源，邹旗，等 . 机器人辅助腹腔镜前列腺癌根治术后患者麻醉复苏期发生低氧血症的危险因素分析 [J]. 机器 人外科学杂志（中英文），2024，5（6）：1030-1035. 

Citation: YIN R, LIU S Y, ZOU Q, et al. Risk factors for hypoxemia in patients recovering from anesthesia after robot-assisted laparoscopic radical prostatectomy[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1030-1035.

[1] 李名城 , 张学平 , 章语 . 机器人辅助手术在前列腺癌患者中的 应用效果及术后并发症分析 [J]. 机器人外科学杂志 ( 中英文 ), 2023, 4(3): 227-232. 

[2] Haney C M, Kowalewski K F, Westhoff N, et al. Robot-assisted versus conventional laparoscopic radical prostatectomy: a systematic review and meta-analysis of randomised controlled trials[J]. Eur Urol Focus, 2023, 9(6): 930-937. 

[3] Falkensammer E, Erenler E, Johansen T E B, et al. Antimicrobial prophylaxis in robot-assisted laparoscopic radical prostatectomy: a systematic review[J]. Antibiotics (Basel), 2023, 12(12): 1744. 

[4] Moretti T B C, Magna L A, Reis L O. Open, laparoscopic, and robot-assisted radical prostatectomy oncological results: a reverse systematic review[J]. J Endourol, 2023, 37(5): 521-530. 

[5] Altaylouni T, Gebert P, Elezkurtaj S, et al. Robot-assisted laparoscopic prostatectomy experience and pathological quality: are they always linked?[J]. J Endourol, 2023, 37(9): 995-1000. 

[6] 李颖 , 郭驹 , 通耀威 , 等 . 急性 Stanford A 型主动脉夹层术前 低氧血症危险因素的 Meta 分析 [J]. 中国体外循环杂志 , 2022, 20(1): 3-7. 

[7] 徐宇 , 龚昆梅 , 郭世奎 . 急性 A 型主动脉夹层术后发生低氧血症 危险因素的 Meta 分析 [J]. 转化医学杂志 , 2022, 11(6): 355-359. 

[8] 邹旗 , 许孟楠 , 梁辉 , 等 . 减重代谢手术病人麻醉苏醒期低氧 血症预测模型的构建与验证 [J]. 护理研究 , 2023, 37(21): 3813- 3819. 

[9] LU W N, LIU C Y, HE J, et al. Surgical and medical co-management optimizes surgical outcomes in older patients with chronic diseases undergoing robot-assisted laparoscopic radical prostatectomy[J]. Aging Male, 2023, 26(1): 2159368. 

[10] radical FAN S prostatectomy B, HAO H, CHEN using the S L, Kangduo et al. Robot surgical -assisted robot system laparoscopic vs the da Vinci Si robotic system[J]. J Endourol, 2023, 37(5): 568-574. 

[11] Haapiainen H, Murtola T J, Koskimäki J, et al. Robot-assisted versus three-dimensional laparoscopic radical prostatectomy: 12-month outcomes of a randomised controlled trial[J]. BJU Int, 2023, 132(5): 505-511. 

[12] Swenson K E, Hardin C C. Pathophysiology of hypoxemia in COVID-19 lung disease[J]. Clin Chest Med, 2023, 44(2): 239-248. 

[13] Hartigan P M. Hypoxemia and Endobronchial Valves[J]. J Cardiothorac Vasc Anesth, 2023, 37(10): 2114-2115. 

[14] Johnson J, Yang Y, Bian Z, et al. Systemic hypoxemia induces cardiomyocyte hypertrophy and right ventricular specific induction of proliferation[J]. Circ Res, 2023, 132(6): 723-740. 

[15] 黄秋瑞 , 王明明 , 李华 , 等 . 老年患者全麻后麻醉恢复室发生低 氧血症的危险因素 [J]. 临床麻醉学杂志 , 2023, 39(6): 582-585. 

[16] Sjödahl Matsson V, Ekström M. Peripheral oxygen saturation misclassifies hypoxemia[J]. Ann Am Thorac Soc, 2023, 20(7): 1070-1073. 

[17] Thomson H M, Shah S. 27-year-old woman with hypoxemia[J]. Mayo Clin Proc, 2023, 98(11): 1702-1706. 

[18] 阿里木江·司马义 , 王晓丽 , 瞿莉 , 等 . 肥胖患者腹腔镜胃减容 术后早期低氧血症危险因素分析 [J]. 国际麻醉学与复苏杂志 , 2024, 45(1): 31-35. 

[19] 韩邦桂 , 曾永恒 , 陆圣光 , 等 . 全身麻醉眼科手术患儿术后新 发低氧血症危险因素分析 [J]. 国际麻醉学与复苏杂志 , 2021, 42(11): 1191-1194. 

[20] 谢晨 , 游月烊 , 孙凯 , 等 . 胸腔镜手术麻醉苏醒期低氧血症危险 因素分析 [J]. 国际麻醉学与复苏杂志 , 2020, 41(4): 355-359. 

[21] 李训良 , 陈曼 , 王春亭 , 等 . 术后转入 ICU 患者出现低氧血症的 危险因素分析 [J]. 中华危重病急救医学 , 2022, 34(2): 161-166. 

[22] 魏华 , 甘祥芝 , 王德林 , 等 . 加速康复外科理念在机器人辅助腹 腔镜下前列腺癌根治术中的应用及效果观察 [J]. 机器人外科学 杂志 ( 中英文 ), 2023, 4(6): 549-555. 

[23] 向玉萍 , 曾玲 , 罗天会 , 等 . 冠状动脉旁路移植术后低氧血症危 险因素的系统评价与 Meta分析[J].中国胸心血管外科临床杂志 , 2020, 27(8): 926-932. 

[24] Cunningham C A, Rappaport D E. 28-year-old woman with refractory hypoxemia[J]. Mayo Clin Proc, 2023, 98(12): 1863-1868.