目的：探讨意义疗法对机器人辅助肾移植术后肾功能丧失再行血液透析患者的影响。方法：选取 2018 年 1 月—2023 年 6 月首都医科大学附属北京友谊医院行达芬奇机器人辅助肾移植手术的 80 例血液透析患者，按照信封法分为对照组和观察组， 每组各 40 例。对照组采用常规治疗，观察组在对照组基础上采用意义疗法，分析并比较两组患者的肾功能指标、心理状况、 应对方式及生活质量。结果：治疗后，观察组的血清尿素氮（BUN）、肌酐（Cr）水平低于对照组，肌酐清除率（Ccr）高 于对照组（P<0.05）；观察组的汉密尔顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）评分低于对照组（P<0.05），肾 脏疾病生活质量简表（KDQOL-SF）评分高于对照组（P<0.05）；观察组在积极应对等方面的简易应对方式问卷（SCSQ）评 分高于对照组，消极应对等方面的 SCSQ 评分低于对照组（P<0.05）。结论：意义疗法可有效提高机器人辅助肾移植术后肾 功能丧失再行血液透析患者的肾功能，并改善患者的不良心理状况，使其积极面对疾病，进而提高生活质量，临床值得推广。

Objective: To explore the effect of meaning therapy on patients who accepted hemodialysis after loss of renal function following robot-assisted kidney transplantation. Methods: 80 hemodialysis patients who underwent Da Vinci robot-assisted kidney transplantation in Beijing Friendship Hospital of Capital Medical University from January 201 to June 2023 were selected. They were divided into the control group (using routine treatment, n=40) and the observation group (using meaning therapy on the basis of routine treatment, n=40) using the envelope method. The renal function indicators, psychological statu, coping style, and quality of life of patients in the two groups were analyzed and compared. Results: After treatment, the blood urea nitrogen (BUN) level, creatinine (Cr) level, Hamilton Anxiety Scale (HAMA) score, and Hamilton Depression Scale (HAMD) score in the observation group were lower than those in the control group, While the creatinine clearance (Ccr) and Kidney Disease Quality of Life Short Form (KDQOL-SF) scores were higher than those in the control group (P<0.05). For the Simple Coping Style Questionnaire (SCSQ), the observation group had a higher score in positive coping and a lower score in negative coping compared with the control group (P<0.05). Conclusion: Meaning therapy can effectively improve the renal function of patients who accepted hemodialysis after loss of renal function following robotassisted kidney transplantation, improve patients’ adverse psychological status and help them actively face the disease, as well as raise their quality of life, which is worth promoting in clinical practice.

基金项目：国家自然科学基金（82003833） 

Foundation Item: National Natural Science Foundation of China(82003833) 

引用格式：刘珂，王丽妍 . 意义疗法对机器人辅助肾移植术后肾功能丧失再行血液透析患者的影响 [J]. 机器人外科学杂志（中英文）， 2025，6（3）：475-480. 

Citation: LIU K, WANG L Y. Effect of meaning therapy on patients who accepted hemodialysis after loss of renal function following robotassisted kidney transplantation [J]. Chinese Journal of Robotic Surgery, 2025, 6(3): 475-480. 

通讯作者（Corresponding Author）：王丽妍（WANG Liyan），Email：wangliyan7731@sina.com

[1] Yozgat I, Cakır U, Serdar M A, et al. Longitudinal non-targeted metabolomic profiling of urine samples for monitoring of kidney transplantation patients[J]. Ren Fail, 2024, 46(1): 2300736. 

[2] 沈百欣 , 倪斌 , 张俊麒 , 等 . 机器人辅助经腹膜后入路单孔腹腔镜下 活体供肾切取术 : 全球首例报道 ( 附视频 )[J]. 机器人外科学杂志 ( 中 英文 ), 2024, 5(2): 233-237. 

[3] 宋晓波 , 肖明朝 , 易凤琼 , 等 . 达芬奇机器人手术运营效率影响因素 分析 [J]. 机器人外科学杂志 ( 中英文 ), 2024, 5(1): 45-49. 

[4] Territo A, Bajeot A S, Mesnard B, et al. Open versus robotic-assisted kidney transplantation: a systematic review by the European Association of Urology (EAU)- Young Academic Urologists (YAU) kidney transplant working group[J]. Actas Urol Esp (Engl Ed), 2023, 47(8): 474-487. 

[5] 臧格 , 时秋英 , 李博 , 等 . 肾移植术后肾功能丧失再行血液透析患者 心理感受的质性研究 [J]. 护士进修杂志 , 2022, 37(20): 1894-1897. 

[6] de Medeiros A Y B B V, Pereira E R, Silva R M C R A. The meaning of life and religious coping in the fight against cancer: a study with oncology patients in brazil in light of viktor frankl’s theory[J]. J Relig Health, 2024, 63(2): 1373-1389. 

[7] 邓雨欣 , 韦琦 , 蔡祥礽 , 等 . 癌症管理与生命意义疗法在癌症患者中 应用的范围综述 [J]. 中国实用护理杂志 , 2023, 39(34): 2707-2713. 

[8] Goto S, Fujii H, Mieno M, et al. Survival benefit of living donor kidney transplantation in patients on hemodialysis[J]. Clin Exp Nephrol, 2024, 28(2): 165-174. 

[9] Ernst BLV, Kreher D, Patschan D, et al. Self-efficacy, social support and oral health-related quality of life in patients with kidney transplantation and under hemodialysis[J]. BMC Nephrol, 2024, 25(1): 441. 

[10] Rabinowitz J, Williams J B W, Hefting N, et al. Consistency checks to improve measurement with the hamilton rating scale for anxiety (HAM-A)[J]. J Affect Disord, 2023. DOI: 10.1016/j.jad.2023.01.029. 

[11] Santi N S, Biswal S B, Naik B N, et al. Comparison of hamilton depression rating scale and montgomery-åsberg depression rating scale: baked straight from a randomized study[J]. Cureus, 2023, 15(9): e45098. 

[12] Nooripour R, Hoseinian S, Vakili Y, et al. Psychometric properties of farsi version of the resilience scale (CD-RISC) and its role in predicting aggression among Iranian athletic adolescent girls[J]. BMC Psychol, 2022, 10(1): 142.

[13] Eweida R S, Rashwan Z I, Khonji L M, et al. Psychological first aid intervention: rescue from psychological distress and improving the prelicensure nursing students’ resilience amidst COVID-19 crisis and beyond[J]. Sci Afr, 2023. DOI: 10.1016/j.sciaf.2022.e01472. 

[14] 王颖 , 吴娟娟 , 许方方 , 等 . 基于老年营养风险指数的分层式饮食治 疗对老年持续性血液透析患者营养状况及自我效能的影响 [J]. 中国 血液净化 , 2022, 21(7): 536-540. 

[15] 尹小文 , 万桂芹 , 李国红 . 血液透析患者实施授权赋能理论下运动 训练对低血压发生率的影响研究 [J]. 中国急救复苏与灾害医学杂志 , 2024, 19(12): 1600-1604. 

[16] Kishore T A, Kaddu D J, Sodhi B S, et al. Robotic kidney transplant beyond the learning curve: 8-year single-center experience and matched comparison with open kidney transplant[J]. Urology, 2024. DOI: 10.1016/ j.urology.2023.10.031. 

[17] Williamson T, Song S E. Robotic surgery techniques to improve traditional laparoscopy[J]. JSLS, 2022, 26(2): e2022.00002. 

[18] 丰永花 , 王志刚 , 谢红昌 , 等 . 儿童肾移植 202 例回顾性分析 [J]. 中 华器官移植杂志 , 2020, 41(1): 20-23. 

[19] MAO Y J, XU D S, LIU S D, et al. An analysis of the relationship between donor and recipient biomarkers and kidney graft function, dysfunction, and rejection[J]. Transpl Immunol, 2023. DOI: 10.1016/j.trim.2023.101934. 

[20] Shaygan M, Khaki S, Zarei D, et al. Effects of meaning-based psychotherapy on post-traumatic growth and death anxiety in patients with cancer: a systematic review and meta-analysis[J]. Support Care Cancer, 2024, 32(4): 251. 

[21] Marco J H, Martinez-Micó A, García-Alandete J, et al. A systematic review of the effectiveness of meaning-centred psychotherapies in depressed participants[J]. Clin Psychol Psychother, 2023. DOI: 10.1002/cpp.2936. 

[22] Heidary M, Heshmati R, Hayes J. Effect of group logotherapy on anxiety about death and existential loneliness in patients with advanced cancer: a randomized controlled trial[J]. Cancer Nurs, 2023, 46(1): E21-E30. 

[23] Eskigülek Y, Kav S. Effect of logotherapy counseling program on chronic sorrow, dignity, and meaning in life of palliative care patients: a randomized controlled trial[J]. Support Care Cancer, 2024 , 32(9): 587. 

[24] Raji Lahiji M, Sajadian A, Haghighat S, et al. Effectiveness of logotherapy and nutrition counseling on psychological status, quality of life, and dietary intake among breast cancer survivors with depressive disorder: a randomized clinical trial[J]. Support Care Cancer, 2022, 30(10): 7997- 8009. 

[25] Lotfifar B, Ghadampour E, Bagheri N. Comparative effectiveness of psychotherapy approaches on death anxiety in multiple sclerosis patients. a pilot randomized controlled trial[J]. Mult Scler Relat Disord, 2021. DOI: 10.1016/j.msard.2021.102914. 

[26] 董翠珍 , 王晓娣 , 曹菲 , 等 . 义疗法治疗对慢性肾小球肾炎患者焦虑、 抑郁情绪影响效果分析 [J]. 中国实用护理杂志 , 2022, 38(14): 1105- 1109. 

[27] Kim C, Choi H. The efficacy of group logotherapy on community-dwelling older adults with depressive symptoms: a mixed methods study[J]. Perspect Psychiatr Care, 2020. DOI: 10.1111/ppc.12635. 

[28] Fereydouni S, Forstmeier S. An islamic form of logotherapy in the treatment of depression, anxiety and stress symptoms in university students in Iran[J]. J Relig Health, 2022, 61(1): 139-157. 

[29] Rahgozar S, Giménez-Llort L. Design and effectiveness of an online group logotherapy intervention on the mental health of Iranian international students in European countries during the COVID-19 pandemic[J]. Front Psychiatry, 2024. DOI: 10.3389/fpsyt.2024.1323774. 

[30] Suarez Luna J C. The postmodern subject from a psychopolitical perspective: an analysis from logotherapy[J]. Medwave. 2024, 24(6): e2799.