目的：分析早期宫颈癌患者行机器人辅助宫颈癌根治术（RRH）后并发症的危险因素，并探讨其护 理对策。方法：选取 2020 年 7 月—2023 年 7 月西北妇女儿童医院行 RRH 治疗的 150 例早期宫颈癌患者作为研究对象。 统计患者住院期间并发症发生情况，根据并发症发生情况分组，将发生并发症患者纳入并发症组，将未发生并发症 患者纳入无并发症组。统计并比较两组患者基线资料，采用二元 Logistic 回归分析影响早期宫颈癌患者 RRH 术后发 生并发症的危险因素；基于相应危险因素采用 R 语言包构建列线图模型。结果：共有 21 例（14.00%）患者发生并发症， 与无并发症组相比，并发症组 BMI ≥ 24 kg/m2 、分化程度为低分化、合并糖尿病患者占比更高，手术时间更长，术 中出血量更多。二元 Logistic 回归分析显示，BMI ≥ 24 kg/m2 、手术时间长、术中出血量、合并糖尿病是宫颈癌患者 RRH 术后发生并发症的危险因素。使用 Bootstrap 法对列线图模型进行内部验证，C-index 值为 0.880，表明模型具有 良好的区分度。绘制 ROC 曲线对列线图模型进行内部验证，列线图模型预测 RRH 患者发生并发症的 AUC 为 0.880， 具有一定预测价值；特异度、敏感度、约登指数分别为 0.752、0.905、0.657。结论：BMI、手术时间、术中出血量 及合并糖尿病与 RRH 患者发生并发症相关，同时基于上述因素构建列线图能够有效预测患者并发症发生风险，未 来临床可根据患者伴随的风险因素进行针对性干预，以降低并发症发生风险。

Objective: To analyze the risk factors of postoperative complications in early-stage cervical cancer patients underwent robot-assisted radical hysterectomy (RRH), and to explore corresponding nursing countermeasures. Methods: 150 patients with early-stage cervical cancer who underwent RRH in Northwest Women’s and Children’s Hospital from July 2020 to July 2023 were selected as the research subjects. Complications occurred during hospitalization were counted, and the 150 patients were grouped into the complication group and the no-complication group according to whether complication occurred or not. The baseline data of patients in the two groups were compared, and the risk factors affecting the occurrence of complications after RRH in patients with early-stage cervical cancer were analyzed using binary logistic regression. A nomogram prediction model was constructed using the R language package based on the corresponding risk factors. Results: A total of 21 patients (14.00%) developed complications. Compared with the no-complication group, the complication group had a higher percentage of patients with BMI ≥ 24 kg/m2 , lower differentiation degree, combining with diabetes mellitus, longer operative time and more intraoperative bleeding. Binary logistic regression analysis results showed that BMI ≥24 kg/m2 , longer operative time, intraoperative bleeding, and combined diabetes mellitus were risk factors for complications in cervical cancer patients after RRH. Bootstrap was used for internal validation of the nomogram prediction model, the C-index value of 0.880 indicated that the model had a good discrimination. The ROC curve was plotted for internal validation of the nomogram prediction model, and the AUC of the nomogram prediction model predicting the occurrence of complications in RRH patients was 0.880, which had certain predictive value. Specificity, sensitivity, and Jordon’s index were 0.752, 0.905, and 0.657, respectively. Conclusion: BMI, operative time, intraoperative bleeding, and combined diabetes mellitus were associated with the occurrence of complications in early-stage cervical cancer patients after RRH, and the nomogram prediction model constructed based on the above factors can effectively predict the risk of complications. Targeted interventions based on patients’ concomitant risk factors can be provided to reduce the risk of complications.

收稿日期：2024-01-15  录用日期：2024-03-14 

Received Date: 2024-01-15  Accepted Date: 2024-03-14 

基金项目：陕西省自然科学基金项目（2019JM-sf-086） 

Foundation Item: Natural Science Foundation of Shaanxi Province (2019JM-sf-086) 

通讯作者：白贝，Email：baibei8716@163.com 

Corresponding Author: BAI Bei, Email: baibei8716@163.com 

引用格式：尹漫，郝晶，张瑾，等 . 早期宫颈癌患者机器人辅助宫颈癌根治术后并发症危险因素分析 [J]. 机器人外科学杂志（中英 文），2024，5（6）：1071-1076. 

Citation: YIN M, HAO J, ZHANG J, et al. Risk factors of postoperative complications after robot-assisted radical hysterectomy for early-stage cervical cancer[J]. Chinese Journal of Robotic Surgery, 2024,5(6): 1071-1076.

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