泌尿外科机器人辅助腹腔镜术后腹胀的机制与防治研究进展
关键词：机器人辅助腹腔镜手术；防治策略；术后腹胀；术后护理；泌尿外科 中图分类号：R473.6文献标志码：A文章编号：2097-7174（2026）03-0276-07 DOI：10.3969/j.issn.2097-7174.2026.03.013
Research progress on the mechanisms and prevention of abdominal distension following robot-asssted laparoscopic surgery in urology
XU Yidan’，LILili²，DING Zeyu’，XUYingna' （1.Schoolof Nursing，Gannan Medical University；2.Departmentof Urology，TheFirst Affiliated Hospital of Gannan Medical University，Ganzhou，Jiangxi ）
Abstract：Robot-assisted laparoscopic surgery（RALS）has become thegold standard inurology，and its minimally invasiveadvantages have been confirmed by numerous evidence-based studies.However，the incidence of postoperative abdominal bloatingafter transperitoneal RALS（TP-RALS） isas high as 40% 55% ，which prolongs hospitalization，increases costs，andafectspatientexperience.Itsmechanismshavenotbeensystematicallsummarized，preventiveandcontrol measuresarenotstandardized.Thisarticlereviews TP-RALS-related abdominal bloating from fouraspects：incidence， risk factors，subjectiveand objective assessment methods，andenhanced recovery aftersurgery based prevention and treatment strategies.Independent risk factors for TP-RALSabdominal bloating includediferent surgical approaches， insuflation pressure，intraoperativebloodloss，opioiduse，and intestinal injury，with thecore mechanism beinga" CO2 （20 pneumoperitoneum-sympatheticactivation-inflammatoryfactors-interstitialcelsofCajaldamage-intestinalparalysis" cascade.Currentclinical evidence showsthatepidural analgesia，gum chewing，and medium-frequency electrical stimu - lationcansignificantlyshorten the time tofirst flatus；integrative Chinese and Western medicine approaches（Houpu flatus-dispelingformula，auricularacupressure withseeds）canadvancefirstflatus by2-18 hours，thoughlarge-sample validation forthelater isstillneeded.In thefuture，multi-centerprospectivecohort studiesshould beconducted to compar theclinicaloutcomesofdiferentsurgicalapproaches，utilizea"ComprehensiveBloatingScoreSheet" tostandardize endpointevaluation，andinitiatelarge-samplerandomizedcontrolledtrials toverifytheeficacyandsafetyofinterventions withtraditional Chinesemedicine，ultimately establishinganevidence-based，precision-oriented，integrativeChinese
Western medicine approach to perioperative bowel function management.
Key Words：Robot-assisted laparoscopic surgery；Preventionandcontrol strategy；Postoperativeabdominal distension; Postoperative care； Urology
随着医疗技术的不断进步，机器人辅助腹腔镜手术（Robot-assisted laparoscopic surgery，RALS）已逐渐成为泌尿外科疾病治疗的重要术式[1]。（剩余13865字）