目的：探讨全程化延续性护理对机器人辅助根治性膀胱切除术（RARC）联合腹壁造口患者自我管理 能力、生活质量和造口并发症的影响。方法：选取 2018 年 1 月—2023 年 9 月行 RARC 联合腹壁造口的 152 例患者， 以随机数表法分为对照组（行常规护理干预，76 例）和研究组（行全程化延续性护理干预，76 例），比较两组患 者的自我管理效能、生活质量和造口并发症发生情况。结果：与干预前比较，干预后 3 个月两组患者癌症自我管理 效能感量表（SUPPH）各维度评分及总分均升高，且研究组 SUPPH 各维度评分及总分高于对照组（P<0.05）。与干 预前比较，干预后 3 个月两组患者欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）中的总体健康、功能 评分升高，症状、特异性评分降低，且研究组总体健康、功能评分高于对照组，症状、特异性评分低于对照组（P<0.05）。 与对照组比较，研究组的周围皮炎发生率及造口总并发症发生率更低（P<0.05）。结论：全程化延续性护理应用于 RARC 联合腹壁造口患者，可提高患者的自我管理能力和生活质量，降低造口并发症发生率。

Objective: To investigate the effects of whole-course continuity of care on the self-management ability, quality of life and stoma complications of patients who underwent robot-assisted radical cystectomy (RARC) combined abdominal wall ostomy. Methods: 152 patients who underwent RARC combined abdominal wall ostomy from January 2018 to September 2023 were selected. They were divided into the control group (n=76) and the study group (n=76) using a random number table. The control group received routine nursing intervention, while the study group received whole-course continuity of care. Self management efficacy, quality of life, and stoma complication of patients in the two groups were compared. Results: Compared with that before intervention, the scores of all dimensions and total scores of strategies used by people to promote health (SUPPH) were all increased in the two groups after 3 months’ intervention, and the scores of all dimensions and total scores of SUPPH in the study group were higher than those in the control group (P<0.05). Compared with that before intervention, patients in both groups at 3 months post-intervention had higher overall health and functioning scores and lower symptom and specificity scores in the European Organization for Research and Treatment of cancer quality of life questionnaire (EORTC QLQ-C30). The overall health and functional scores of the study group were higher than those of the control group, and the symptom and specificity scores were lower than those of the control group (P<0.05). Compared with the control group, the incidence rate of peripheral dermatitis and total stoma complications were lower in the study group (P<0.05). Conclusion: Application of whole-course continuity of care in patients who underwent RARC combined abdominal wall ostomy can improve patients’ self-management ability and quality of life, and reduce the incidence of stoma complications.

收稿日期：2024-02-29  录用日期：2024-04-30 

Received Date: 2024-02-29  Accepted Date: 2024-04-30 

基金项目：陕西省重点研发计划项目（2019JM7152） 

Foundation Item: Key R&D Plan Project of Shaanxi Province (2019JM7152) 

通讯作者：程蕊，Email：yuanxt1991@163.com 

Corresponding Author: CHENG Rui, Email: yuanxt1991@163.com 

引用格式：原晓婷，王李倩，弥长虹，等 . 全程化延续性护理对机器人辅助根治性膀胱切除术联合腹壁造口患者自我管理、生活 质量和造口并发症的影响 [J]. 机器人外科学杂志（中英文），2024，5（6）：1260-1265. 

Citation: YUAN X T, WANG L Q, MI C H, et al. Effect of whole-course continuity of care on self-management, quality of life and stoma complications in patients undergoing robot-assisted radical cystectomy combined with abdominal wall ostomy [J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1260-1265.

[1] LI P, ZHOU H X, CAO H L, et al. Robot-assisted laparoscopic management of bladder/ prostate rhabdomyosarcoma in children: initial series and 1-year outcomes[J]. J Endourol, 2021, 35(10): 1520-1525. 

[2] Goffioul L, Bonnet P, Waltregny D, et al. Parastomal hernia after radical cystectomy with ileal conduit diversion: a narrative review[J]. Acta Chir Belg, 2021, 121(6): 373-379. 

[3] JIN Y F, TIAN X, LI Y Y, et al. Effects of continuous care on health outcomes in patients with stoma: a systematic review and metaanalysis[J]. Asia Pac J Oncol Nurs, 2021, 9(1): 21-31. 

[4] 程锦 . 延续性护理在膀胱癌术后双侧腹壁造口患者中的应用效 果及对自护能力心理弹性影响 [J]. 山西医药杂志 , 2021, 50(11): 1877-1879. 

[5] 陈莉 , 汪涌 , 祝广峰 , 等 .2020 年欧洲泌尿协会肌层浸润性膀 胱癌诊断和治疗指南概要 [J]. 现代泌尿外科杂志 , 2020, 25(11): 1025-1029. 

[6] 马涛 . 延续性护理对肾移植术后出院患者自我管理及生活质量 影响 [J]. 中国药物与临床 , 2020, 20(15): 2651-2652. 

[7] 钱会娟 , 袁长蓉 . 中文版癌症自我管理效能感量表的信效度测 评 [J]. 中华护理杂志 , 2011, 46(1): 87-89. 

[8] 万崇华 , 陈明清 , 张灿珍 , 等 . 癌症患者生命质量测定量表 EORTC QLQ-C30 中文版评介 [J]. 实用肿瘤杂志 , 2005, 20(4): 353-355. 

[9] Ramsay R E, Becker D A, Vazquez B, et al. Acute abortive therapies for seizure clusters in long-term care[J]. J Am Med Dir Assoc, 2023, 24(8): 1225-1232. 

[10] Reckrey J M, Zhao D, Stone R I, et al. Use of home-based clinical care and long-term services and supports among homebound older adults[J]. J Am Med Dir Assoc, 2023, 24(7): 1002-1006.e2. 

[11] 姜凌燕 , 翁丽娜 , 蒋轶波 . 延续性护理对维持性血液透析患 者自我管理能力及生活质量的影响 [J]. 现代中西医结合杂志 , 2023, 32(14): 2025-2028. 

[12] 缪景霞 , 李慧 , 姚志琪 , 等 . 基于微信视频的延续性护理对肠癌 化疗患者 PICC 自我管理能力及导管维护知识的影响 [J]. 现代 临床护理 , 2020, 19(10): 30-35. 

[13] 刘晓阳 , 王娟 , 薛淑敏 , 等 . 延续性护理对老年慢性心力衰竭患 者遵医行为与生活质量的影响研究 [J]. 贵州医药 , 2023, 47(6): 982-983. 

[14] 汪妮 , 熊浪 , 周波 , 等 . 延续性护理对糖尿病肾病透析患者生 活质量及心理状况的影响 [J]. 中国临床新医学 , 2022, 15(11): 1088-1091. 

[15] 杨敏 , 李澜 , 李静 , 等 . 延续性护理对乳腺癌术后化疗患者 PICC 管相关并发症的影响 [J]. 血栓与止血学 , 2022, 28(1): 163- 164, 166. 

[16] 王明艳 , 刘仙黎 , 胡阳 . 延续性护理对膀胱癌术后灌注化疗患 者治疗依从性、护理满意度及生活质量的影响 [J]. 贵州医药 , 2022, 46(3): 495-496. 

[17] 贺徐琳 , 袁静 , 沈丹菁 , 等 . 基于知信行理论的延续性护理方案 在膀胱肿瘤术后灌注中的价值研究 [J]. 中国肿瘤临床与康复 , 2021, 28(9): 1138-1141. 

[18] O’Malley K A, Sullivan J L, Mills W, et al. Trauma-informed care in long-term care settings: from policy to practice[J]. Gerontologist, 2023, 63(5): 803-811. 

[19] 陈海莺 , 黄蓉蓉 , 魏开鹏 . 改良式延续护理在膀胱癌尿路造口 患者的应用效果 [J]. 东南国防医药 , 2021, 23(4): 431-433. 

[20] 陈海燕 , 黄炳琴 , 张庆 . 加速康复外科理念在膀胱癌术后患者 中的应用效果 [J]. 癌症进展 , 2023, 21(4): 446-450. 

[21] 曹建芬 , 石兰萍 , 刘畅 , 等 . 智能化护理风险防控系统的建立与 应用 [J]. 护理学杂志 , 2021, 36(24): 53-56.