【摘要】 目的 探讨基于云随访管理平台的居家自我管理模式在直肠癌经肛门全直肠系膜切除术（taTME）术后患者中的应用效果。方法 选取2020年4月至2021年4月于南充市中心医院胃肠疝外科行taTME的93例直肠癌患者为研究对象，采用随机数字表法分为对照组（n=48，给予常规护理）与观察组（n=45，在对照组基础上给予基于云随访管理平台的居家自我管理）。比较两组自我护理能力【自我护理能力（ESCA）量表】、肛门功能【低位前切除综合征（LARS）评分量表】及生活质量【欧洲癌症研究与治疗组织生存质量问卷（EORTC QLQ-C30）】。结果 干预前，两组ESCA评分（自我概念、自护责任感、自我护理技能、健康知识水平各维度评分及总分）、LARS的严重程度及EORTC QLQ-C30评分（功能维度、症状维度、单项测量项目、总体健康水平）比较差异均无统计学意义（均P>0.05）。干预6个月后，观察组ESCA各维度评分及总分均高于对照组（均P<0.05）；观察组LARS的严重程度较对照组轻（P<0.05）；观察组EORTC QLQ-C30的功能维度评分，症状维度评分，总体健康水平评分及单项测量项目的便秘、腹泻评分均优于对照组（均P<0.05）；两组的单项测量项目的呼吸困难评分、食欲下降评分、睡眠障碍评分、经济困难评分比较差异均无统计学意义（均P>0.05）。结论 基于云随访管理平台的居家自我管理模式有利于改善直肠癌taTME术后患者的自我护理能力、肛门功能及生活质量。更多还原

【Abstract】 Objectives To investigate the effect of self-care management at home model using cloud platform for follow-up in patients undergoing transanal total mesorectal excision(taTME). Methods Ninety-three patients with rectal cancer treated at the Department of Gastrointestinal & Hernia Surgery, Nanchong Central Hospital, between April 2020 and April 2021 were recruited.Patients were randomly assigned to the control group(n=48, receiving routine nursing care) and the treatment group(n=45, receiving self-care management at home model using the cloud platform in addition to routine nursing care). The followings were compared between the two groups: self-care agency as measured with exercise of self-care agency(ESCA), anal function as measured with the low anterior resection syndrome(LARS), and quality of life(QoL) as measured with the EORTC core quality of life questionnaire(EORTC QLQ-C30). Results Before the intervention, the two groups did not differ significantly in ESCA scores(self-concept, initiative and responsibility, self-care skills, knowledge and information seeking of each dimension score and total score), the severity of LARS, and EORTC QLQ-C30 scores(functional scales, symptom scales, single items, and global health status/QoL scale)(P>0.05). Six months after the intervention, ESCA each dimension score and total score were significantly higher in the treatment group than in the control group(P<0.05). LARS was significantly less severe in the treatment group than in the control group(P<0.05). Functional scales scores, symptom scales scores, global health status/QoL scale score, and single items scores of constipation and diarrhea of EORTC QLQ-C30 were significantly better in the treatment group than in the control group(P<0.05). In contrast, the two groups did not significantly differ between single items scores of dyspnea, loss of appetite, insomnia, and perceived financial impacts of the disease(P>0.05). Conclusion Self-care management at home model using the cloud platform for follow-up improves self-care ability, anal function, and QoL for patients undergoing taTME.更多还原