机器人外科学杂志（中英文）2026，Vol.7Issue(5)：771-776,6.DOI:10.12180/j.issn.2096-7721.2026.05.006
围手术期血糖水平对2型糖尿病患者机器人辅助腹腔镜根治性前列腺切除术后切口愈合不良的影响及危险因素分析
Impact of perioperative glycemia on poor wound healing after robot-assisted laparoscopic radical prostatectomy in patients with type 2 diabetes mellitus and its risk factors
摘要
Abstract
Objective:To investigate the impact of perioperative blood glucose levels on poor wound healing after robot-assisted laparoscopic radical prostatectomy(RARP)in prostate cancer patients complicated with type 2 diabetes mellitus(T2DM)and to analyze its risk factors.Methods:Clinical data of 90 prostate cancer patients complicated with T2DM who underwent RARP at Lianyungang First People's Hospital from January 2023 to December 2024 were retrospectively analyzed.Patients were divided into the poor wound healing group(n=18)and the normal wound healing group(n=72)according to whether poor wound healing occurred within 30 days postoperatively.Clinical data,wound healing status,and postoperative length of hospital stay were compared between the two groups.Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for poor postoperative wound healing.Additionally,patients were divided into four groups based on preoperative fasting blood glucose(FBG)and blood glucose levels at postoperative day 1,including well-controlled blood glucose group,postoperative hyperglycemia group,preoperative hyperglycemia group and persistent hyperglycemia group to further analyze the impact of perioperative blood glucose levels on wound healing.Results:Among the 90 patients,18 developed poor wound healing,including 12 cases of wound redness,swelling and exudation,4 cases of wound infection,and 2 cases of wound dehiscence.The poor wound healing group had significantly higher preoperative FBG and glycated hemoglobin(HbA1c)levels and significantly longer postoperative length of hospital stay than the normal wound healing group(P<0.05).Univariate analysis showed that preoperative FBG≥10 mmol/L,HbA1c≥8.5%,BMI≥28 kg/m2,and operative time≥180 minutes were associated with poor postoperative wound healing(P<0.05).Multivariate logistic regression analysis indicated that preoperative FBG≥10 mmol/L and HbA1c≥8.5%were independent risk factors for poor postoperative wound healing.Further analysis of perioperative blood glucose levels on wound healing showed that the persistent hyperglycemia group had the highest incidence of poor wound healing,with statistically significant differences among groups(P<0.05).Conclusion:Preoperative FBG≥10 mmol/L and HbA1c≥8.5%are independent risk factors for poor wound healing after RARP in patients with T2DM.Enhanced preoperative blood glucose management and postoperative blood glucose monitoring and control are recommended.FBG should be controlled below 10 mmol/L to reduce the risk of postoperative wound complications.关键词
前列腺癌/机器人辅助腹腔镜手术/糖尿病/空腹血糖/切口愈合不良Key words
Prostate Cancer/Robot-assisted Laparoscopic Surgery/Diabetes Mellitus/Fasting Blood Glucose/Poor Wound Healing分类
医药卫生引用本文复制引用
陈兆旭,代佳欣,吉振帅,谢程,张坤,蔡成宽..围手术期血糖水平对2型糖尿病患者机器人辅助腹腔镜根治性前列腺切除术后切口愈合不良的影响及危险因素分析[J].机器人外科学杂志（中英文）,2026,7(5):771-776,6.基金项目
江苏省中医药科研项目(YB2020074)Jiangsu Provincial Scientific Research Project on Traditional Chinese Medicine(YB2020074) （YB2020074）
