目的：研究并分析叙事医学护理模式对机器人辅助根治性肾切除术患者术后身心康复的应用与影响。 方法：采用前瞻性研究方式，选取 2020 年 2 月—2023 年 6 月于空军军医大学第一附属医院接受达芬奇机器人辅助 根治性肾切除术的患者106例。采用随机数字表法将其分为对照组（53例，行常规围手术期干预管理）和观察组（53例， 行常规围手术期干预管理 + 叙事医学护理模式）。比较两组患者临床指标、负性情绪、生活质量与并发症发生情况。 结果：与对照组相比，观察组术后 48 h 疼痛评分更低，流管拔除时间、导尿管拔除时间、肛门排气时间、进食时间、 首次下床时间、住院天数更短，住院费用更少（P<0.05）。焦虑自评量表（SAS）和抑郁自评量表（SDS）评分主体 内效应（F 时点、F 交互）、主体间效应（F 组间）比较，差异均有统计学意义（P<0.05）。术后 5 d 时，患者 SAS、SDS 评分低于入院时及术前 1 d，且观察组 SAS、SDS 评分低于对照组（P<0.05）。干预后，两组患者生活质量综合评定 问卷（GQOLI-74）各项评分及总分均增加，且与对照组相比，观察组 GQOLI-74 各项评分及总分更高（P<0.05）。 与对照组相比，观察组并发症总发生率更低（P<0.05）。结论：叙事医学护理模式能够显著提高达芬奇机器人辅助 根治性肾切除术患者的康复效率，改善负性情绪与生活质量，降低并发症发生率，值得临床推广。

Objective: To analyze the application effect of narrative nursing on postoperative physical and psychological recovery of patients who undevwent robot-assisted radical nephrectomy. Methods: A prospective study was conducted on 106 patients who underwent Da Vinci robot-assisted radical nephrectomy in the First Affiliated Hospital of Air Force Military Medical University from February 2020 to June 2023. They were divided into the control group (n=53) and the observation group (n=53) using a random number table. The control group received routine perioperative intervention, while the observation group received routine perioperative intervention combined with narrative nursing. Clinical indicators, negative emotions, quality of life and complications of patients in the two groups were compared. Results: Compared with the control group, the observation group had lower postoperative pain scores at 48 h after surgery, shorter removal time of drainage tube, catheter removal time, anal defecation time, feeding time, first time out of bed, length of hospital stay, and lower hospitalization costs (P<0.05). Comparison of the within-subject effect (Ftimepoint, Finteraction) and between-subject effect (Fintergroup) of the self-rating anxiety scale (SAS) and self- rating depression scale (SDS) scores showed statistically significant differences (P<0.05). At 5 d after surgery, patients’ SAS and SDS scores were lower than those at the time of admission and 1 d before surgery, and the SAS and SDS scores of the observation group were lower than those of the control group (P<0.05). After intervention, the scores and total scores of comprehensive quality of life assessment questionnaire (GQOLI-74) were both increased in the two groups, and the scores and total scores of GQOLI-74 were higher in the observation group than those in the control group (P<0.05). The total incidence rate of complications was lower in the observation group than that in the control group (P<0.05). Conclusion: Narrative nursing can significantly enhance the rehabilitation efficiency of patients who underwent Da Vinci robot-assisted radical nephrectomy, improve patients’ negative emotions and quality of life, and reduce the incidence of complications, which is worthy of clinical promotion.

收稿日期：2024-03-18  录用日期：2024-04-28 

Received Date: 2024-03-18  Accepted Date: 2024-04-28

基金项目：陕西省重点研发计划项目（2017ZDXM-SF-045） 

Foundation Item: Key R & D Plan Project of Shaanxi Province(2017ZDXM-SF-045) 

通讯作者：郭一梅，Email：263327168@qq.com 

Corresponding Author: GUO Yimei, Email: 263327168@qq.com 

引用格式：魏文静，李嵘，陈盼盼，等 . 叙事医学护理对机器人辅助根治性肾切除术患者术后康复的影响 [J]. 机器人外科学杂志（中 英文），2024，5（6）：1241-1247. 

Citation: WEI W J, LI R, CHEN P P, et al. Effect of narrative nursing on postoperative recovery of patients underwent robotassisted radical nephrectomy[J]. Chinese Journal of Robotic Surgery, 2024,5(6): 1241-1247.

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