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Article(id=1322169048046097407, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168583854080893, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.08.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1748966400000, receivedDateStr=2025-06-04, revisedDate=1775145600000, revisedDateStr=2026-04-03, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159265767, onlineDateStr=2026-10-28, pubDate=1777046400000, pubDateStr=2026-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159265767, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159265767, creator=13701087609, updateTime=1793159265767, updator=13701087609, issue=Issue{id=1322168583854080893, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='8', pageStart='1241', pageEnd='1424', issueExtLink='null', onlineDate='null', pubDate='1777046400000', pubDateStr='2026-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159155095, creator='13701087609', updateTime=1793159155095, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1323, endPage=1327, ext={EN=ArticleExt(id=1322169048247424000, articleId=1322169048046097407, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application of convex base combined with body position nursing intervention in patients with enterostomy, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the application effect of convex base combined with body position nursing intervention in patients with enterostomy.

Methods

From May 2024 to March 2025,a total of 166 patients who underwent colorectal cancer surgery and received enterostomy at the gastrointestinal center of a tertiary grade A hospital were selected and randomly divided into an observation group of 84 cases and a control group of 82 cases.The observation group received convex base combined with body position nursing for the enterostomy,while the control group received traditional flat base combined with lying position care for the enterostomy.The hospitalization duration,incidence of enterostomy-related complications,quality of life scores,biomechanical indicators,and nursing satisfaction of the two groups were compared.

Results

The hospitalization duration,incidence of complications,biomechanical indicators quality of life scores,and nursing satisfaction of the observation group were all better than those of the control group(P<0.05).

Conclusions

Convex base combined with body position nursing for patients with enterostomy could effectively shorten the hospitalization duration of patients,reduce the incidence of enterostomy-related complications,and improve patient satisfaction.

, authors=Suqing CHEN, Wenjuan XU, Lingyun TIAN, authorsList=Suqing CHEN, Wenjuan XU, Lingyun TIAN, authorCompany=null, correspAuthors=Suqing CHEN, authorNote=null, correspAuthorsNote=
CHEN Suqing， E-mail：
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目的

研究凸面底盘协同体位护理干预在肠造口病人中的应用效果。

方法

选取2024年5月—2025年3月在某三级甲等医院胃肠中心行结直肠癌手术肠造口的166例病人，随机分为观察组84例和对照组82例。观察组采用凸面底盘联合坐位护理造口，对照组采用传统平面底盘联合卧位护理造口，比较两组病人住院时长、造口相关并发症发生率、生活质量评分、生物力学指标和护理满意度。

结果

观察组病人住院时长、并发症发生率、生活质量得分、生物力学指标和护理满意度均优于对照组（P<0.05）。

结论

凸面底盘协同体位护理应用于肠造口病人可有效缩短病人住院时长，降低造口相关并发症发生率，提高病人满意度。

, authors=陈素清, 徐文娟, 田凌云, authorsList=陈素清, 徐文娟, 田凌云, authorCompany=null, correspAuthors=陈素清, authorNote=null, correspAuthorsNote=
CHEN Suqing， E-mail：
陈素清，副主任护师，硕士研究生，E-mail：
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language=null, rfNumber=16, rfOrder=15, authorNames=薛静, 韩思娟, 罗佳琳, journalName=保健医学研究与实践, refType=null, unstructuredReference=薛静,韩思娟,罗佳琳,等.基于结构式家庭疗法的随访护理管理模式对直肠癌结肠造口术患者预后的影响[J].保健医学研究与实践,2024,21(9):112-118., articleTitle=基于结构式家庭疗法的随访护理管理模式对直肠癌结肠造口术患者预后的影响, refAbstract=null), Reference(id=1322530543279911815, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, doi=null, pmid=null, pmcid=null, year=2024, volume=43, issue=1, pageStart=106, pageEnd=110, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=张艳侠, 张荆晓, 韩玉环, journalName=国际护理学杂志, refType=null, unstructuredReference=张艳侠,张荆晓,韩玉环,等.Snyder希望理论的护理干预对结肠造口患者应对方式、希望水平及心理状态的影响[J].国际护理学杂志,2024,43(1):106-110., articleTitle=Snyder希望理论的护理干预对结肠造口患者应对方式、希望水平及心理状态的影响, refAbstract=null), Reference(id=1322530543342826376, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, doi=null, pmid=null, pmcid=null, year=2021, volume=27, issue=21, pageStart=2896, pageEnd=2900, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=张志琴, 张连香, 赵海蓉, journalName=中华现代护理杂志, refType=null, unstructuredReference=张志琴,张连香,赵海蓉.医护患责任联动护理干预方案在肠造口患者院外康复管理中的应用[J].中华现代护理杂志,2021,27(21):2896-2900., articleTitle=医护患责任联动护理干预方案在肠造口患者院外康复管理中的应用, refAbstract=null), Reference(id=1322530543422518153, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, doi=null, pmid=null, pmcid=null, year=2023, volume=33, issue=21, pageStart=3353, pageEnd=3356, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=齐琳娜, 宋利芳, 端木艳丽, journalName=中华医院感染学志, refType=null, unstructuredReference=齐琳娜,宋利芳,端木艳丽,等.基于达标理论的支持性照护方案在Miles术后结肠造口并发感染临床护理中的应用效果[J].中华医院感染学志,2023,33(21):3353-3356., articleTitle=基于达标理论的支持性照护方案在Miles术后结肠造口并发感染临床护理中的应用效果, refAbstract=null), Reference(id=1322530543489627018, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, doi=null, pmid=null, pmcid=null, year=2022, volume=19, 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articleId=1322169048046097407, companyId=1322530537223336787, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1山西白求恩医院（山西医学科学院），山西医科大学第三医院，同济山西医院，山西 030032)])], figs=[ArticleFig(id=1322530539995771759, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=EN, label=Table 1, caption=

Comparison of general information between two groups of patients

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组别例数年龄（岁）性别（例）体质指数（kg/m²）TNM分期（例）手术类型（例）
男女Ⅰ期Ⅱ期Ⅲ期开放手术微创手术
P>0.05>0.05>0.05>0.05>0.05
观察组8461.3±9.2434124.6±2.42642162262
对照组8261.7±9.0394324.7±2.32339202557
), ArticleFig(id=1322530540314538864, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=CN, label=表1, caption=

两组病人一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄（岁）性别（例）体质指数（kg/m²）TNM分期（例）手术类型（例）
男女Ⅰ期Ⅱ期Ⅲ期开放手术微创手术
P>0.05>0.05>0.05>0.05>0.05
观察组8461.3±9.2434124.6±2.42642162262
对照组8261.7±9.0394324.7±2.32339202557
), ArticleFig(id=1322530540394230641, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=EN, label=Table 2, caption=

Comparison of hospital stay, complication rate and DET scores between two groups of patients

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组别例数住院时长(d)术后4周并发症发生率（%）DET评分（分）
渗漏刺激性皮炎造口旁疝合计
对照组8211.24±1.579.7610.982.4423.172.8±1.1
观察组8410.09±1.243.574.760.008.331.2±0.5
统计值t=5.02χ²=6.92t=9.24
P<0.0010.009<0.001
), ArticleFig(id=1322530540473922418, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=CN, label=表2, caption=

两组住院时长、并发症发生率及DET评分比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数住院时长(d)术后4周并发症发生率（%）DET评分（分）
渗漏刺激性皮炎造口旁疝合计
对照组8211.24±1.579.7610.982.4423.172.8±1.1
观察组8410.09±1.243.574.760.008.331.2±0.5
统计值t=5.02χ²=6.92t=9.24
P<0.0010.009<0.001
), ArticleFig(id=1322530540754940787, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=EN, label=Table 3, caption=

Comparison of Stoma-QOL scores and nursing satisfaction ratings between two groups of patients

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组别例数Stoma-QOL（分）护理满意度（%）
生理功能心理适应社会参与性活动与身体形象
对照组8218.42±3.2117.35±3.0812.10±3.406.64±2.8980.49
观察组8422.76±2.8521.18±2.6716.30±2.1011.79±2.0394.05
统计值t=-9.08t=-8.72t=-6.69t=-12.35χ2=6.28
P<0.001<0.001<0.001<0.0010.012
), ArticleFig(id=1322530540830438260, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=CN, label=表3, caption=

两组病人Stoma-QOL得分及护理满意度比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数Stoma-QOL（分）护理满意度（%）
生理功能心理适应社会参与性活动与身体形象
对照组8218.42±3.2117.35±3.0812.10±3.406.64±2.8980.49
观察组8422.76±2.8521.18±2.6716.30±2.1011.79±2.0394.05
统计值t=-9.08t=-8.72t=-6.69t=-12.35χ2=6.28
P<0.001<0.001<0.001<0.0010.012
), ArticleFig(id=1322530540914324341, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=EN, label=Table 4, caption=

Comparison of biomechanical indicators between two groups

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数最大接触压力(kPa)180°剥离强度(N/cm)
对照组82120±402.1±0.3
观察组84180±303.2±0.4
t值-5.67-10.62
P<0.001<0.001
), ArticleFig(id=1322530541157593974, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322169048046097407, language=CN, label=表4, caption=

两组生物力学指标比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数最大接触压力(kPa)180°剥离强度(N/cm)
对照组82120±402.1±0.3
观察组84180±303.2±0.4
t值-5.67-10.62
P<0.001<0.001
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凸面底盘协同体位护理干预在肠造口病人中的应用
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陈素清 , 徐文娟 , 田凌云
护理研究 | 综合研究 2026,40(8): 1323-1327
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护理研究 |综合研究 2026 , 40 (8) : 1323 -1327
凸面底盘协同体位护理干预在肠造口病人中的应用
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陈素清 , 徐文娟, 田凌云
作者信息
  • 1山西白求恩医院（山西医学科学院），山西医科大学第三医院，同济山西医院，山西 030032
通讯作者:
CHEN Suqing， E-mail：
陈素清，副主任护师，硕士研究生，E-mail：
Application of convex base combined with body position nursing intervention in patients with enterostomy
Suqing CHEN , Wenjuan XU, Lingyun TIAN
Affiliations
  • 1Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Shanxi 030032 China
    • Corresponding Author:
    CHEN Suqing， E-mail：
出版时间: 2026-04-25 doi: 10.12102/j.issn.1009-6493.2026.08.011
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摘要
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目的

研究凸面底盘协同体位护理干预在肠造口病人中的应用效果。

方法

选取2024年5月—2025年3月在某三级甲等医院胃肠中心行结直肠癌手术肠造口的166例病人，随机分为观察组84例和对照组82例。观察组采用凸面底盘联合坐位护理造口，对照组采用传统平面底盘联合卧位护理造口，比较两组病人住院时长、造口相关并发症发生率、生活质量评分、生物力学指标和护理满意度。

结果

观察组病人住院时长、并发症发生率、生活质量得分、生物力学指标和护理满意度均优于对照组（P<0.05）。

结论

凸面底盘协同体位护理应用于肠造口病人可有效缩短病人住院时长，降低造口相关并发症发生率，提高病人满意度。

结直肠癌  /  凸面底盘  /  体位护理  /  肠造口  /  护理干预
Objective

To study the application effect of convex base combined with body position nursing intervention in patients with enterostomy.

Methods

From May 2024 to March 2025,a total of 166 patients who underwent colorectal cancer surgery and received enterostomy at the gastrointestinal center of a tertiary grade A hospital were selected and randomly divided into an observation group of 84 cases and a control group of 82 cases.The observation group received convex base combined with body position nursing for the enterostomy,while the control group received traditional flat base combined with lying position care for the enterostomy.The hospitalization duration,incidence of enterostomy-related complications,quality of life scores,biomechanical indicators,and nursing satisfaction of the two groups were compared.

Results

The hospitalization duration,incidence of complications,biomechanical indicators quality of life scores,and nursing satisfaction of the observation group were all better than those of the control group(P<0.05).

Conclusions

Convex base combined with body position nursing for patients with enterostomy could effectively shorten the hospitalization duration of patients,reduce the incidence of enterostomy-related complications,and improve patient satisfaction.

colorectal cancer  /  convex base  /  body position nursing  /  enterostomy  /  nursing intervention
陈素清, 徐文娟, 田凌云. 凸面底盘协同体位护理干预在肠造口病人中的应用. 护理研究, 2026 , 40 (8) : 1323 -1327 . DOI: 10.12102/j.issn.1009-6493.2026.08.011
Suqing CHEN, Wenjuan XU, Lingyun TIAN. Application of convex base combined with body position nursing intervention in patients with enterostomy[J]. Chinese Nursing Research, 2026 , 40 (8) : 1323 -1327 . DOI: 10.12102/j.issn.1009-6493.2026.08.011
正文
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近年来，结直肠癌（colorectal cancer,CRC）发病率持续上升，已成为全球范围内严重威胁人类健康的常见恶性肿瘤之一。据统计，2022年全球新发结直肠癌病例占全部恶性肿瘤的10.0%，死亡率为9.4%，我国新发病例达51.71万例[1-3]。肠造口术作为结直肠癌常见手术方式之一，尽管在肿瘤切除与排泄功能重建中具有重要意义，但术后造口并发症（如渗漏、皮炎、造口旁疝）发生率较高，严重影响病人生活质量并增加医疗负担[4]。护理实践中强调造口周围皮肤的密闭保护，以延长造口装置使用时间并预防并发症[5-6] ，从而缩短病人住院时长，提高病人就医感受。凸面底盘因其凹凸设计，能更好地贴合皮肤表面曲线，封闭性好，已被广泛用于低平或回缩造口的管理中[7]。造口病人除了匹配合适的造口产品外，体位管理同样在造口护理中发挥着重要作用。术后早期体位变换频繁、坐位时间延长，可能导致底盘与皮肤贴合不良，从而诱发渗漏与皮肤损伤[8]。基于此，本研究引入凸面底盘协同坐位护理干预模式，旨在探索该模式在肠造口管理中对病人住院时长及并发症的影响，为临床实践提供循证支持，助力肠造口护理由经验走向标准化。
1　对象与方法
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1.1　研究设计
本研究为前瞻性随机对照试验，严格遵循临床试验报告规范(CONSORT)，采用双盲设计，研究对象及数据收集人员均不知晓分组情况，干预实施由独立于研究团队的造口治疗师完成。所有参与者均签署书面知情同意书。研究周期设定为肠造口病人术前直至术后4周，主要观察结局指标包括肠造口病人住院时长、造口并发症发生率，次要指标涵盖生物力学参数、生活质量评分及护理满意度。
1.2　研究对象
于2024年5月—2025年3月，选取某三级甲等医院胃肠中心连续收治的结直肠癌术后肠造口病人172例为研究对象。纳入标准：病理确诊为结直肠癌（美国癌症联合委员会TNM分期为Ⅰ~Ⅲ期）；首次行永久性或者临时性肠造口病人；造口位置位于腹直肌外侧缘；年龄18~75岁；体质指数（BMI）为18.5~28.0 kg/m2；病历资料较为完整；病人知情并同意参与研究。排除标准：合并糖尿病；术前接受新辅助放化疗；存在腹壁疝或造口旁疝；认知功能障碍；其他严重内科疾病或无法配合研究的情况。本研究以住院时长及并发症发生率为主要结局指标，利用PASS 15软件计算所需样本量。根据预试验，对照组发生率为20%，观察组发生率为5%，双侧检验α=0.05，Power为0.80，输入PASS 15软件Tests for Two Proportions计算每组至少需要73例，考虑失访、脱落情况，两组各选取86例病人。本研究已获得医院伦理委员会批准（审批号：SBQLL-2024-371），病人均签署知情同意书。
1.3　干预方法
1.3.1　观察组
实施凸面底盘协同体位护理干预方案，选用康乐保公司凸面底盘，凸起高度≤6.0 mm，配套弹性腰带（压力值15~20 mmHg）。术后1 d维持床头抬高30°，2 h协助病人轴向翻身1次，以避免腹部扭曲；术后2~4 d逐步过渡至45°~90°半卧位，每日进行3次坐位训练（每次20 min）；术后2、3、4 d家属协助病人步行250、500、750 m，每日3次；术后5 d至出院阶段病人维持90°坐位，每日进行3次坐位训练（每次20 min），术后5 d至病人出院家属协助病人步行1 000 m，每日3次。术后1 d至出院期间，护士为病人造口护理时指导病人双手支撑床沿并配合腹式呼吸（6~8/min）。底盘更换操作严格遵循标准化流程：病人取坐位后使用造口测量尺精确测量造口直径（精度0.5 mm），沿皮肤皱褶方向由内向外按压底盘并持续加压60 s（Tekscan®压力传感器监测确保20~25 N）。接受每日造口评估（颜色、水肿、出血等）、标准化健康教育（视频教学+图文手册），出院后每周电话随访。
1.3.2　对照组
采用康乐保公司传统平面底盘，术后平卧位护理，允许自主选择体位，按常规方法更换底盘且无特殊加压操作。接受每日造口评估（颜色、水肿、出血等）、标准化健康教育（视频教学+图文手册），出院后每周电话随访。
1.4　评价指标
1.4.1　主要结局指标
1.4.1.1　住院时长
住院时长从手术日至病人达到出院标准的时间计算。出院标准：体温低于37.5 ℃并持续48 h、造口排气排便恢复正常、伤口无感染，病人家属在无护士协助的情况下独立完成病人造口袋的更换。该指标可反映病人术后恢复情况以及护理干预的有效性。
1.4.1.2　造口并发症发生率
术后4周内的造口并发症发生率是本研究的主要结局指标。依据国际造口协会（WCET）标准[8]，记录渗漏、刺激性皮炎和造口旁疝3种造口并发症的发生情况。
1.4.1.3　皮肤损伤程度
采用造口皮肤评估工具（DET）[9]进行评估，总分为0~15分。
1.4.2　次要结局指标
1.4.2.1　生活质量评分
采用中文版造口生活质量量表（Stoma-QOL）[10]评估生活质量。该量表包括生理功能、心理适应、性活动与身体形象和社会参与4个维度，共20个条目，内部一致性信度（Cronbach's α系数）为0.91，可全面反映病人术后生活质量。
1.4.2.2　护理满意度
护理满意度采用Likert 5级评分量表进行评估，其中评分≥4分即视为满意。该指标可反映病人对护理措施的接受度。
1.4.3　生物力学指标
1.4.3.1　底盘黏附强度
采用180°剥离试验[11]测定底盘的黏附强度，以评估不同护理模式对底盘固定性的影响。底盘黏附强度的测定有助于判断护理措施对造口护理用品稳定性的优化作用，决定病人造口袋更换频次，是否影响病人住院时长。
1.4.3.2　最大接触压力
采用Tekscan®压力传感系统测量病人坐位时的最大接触压力，以评估不同护理模式对病人坐位舒适度的影响。该参数可用于分析护理干预是否能有效减少局部压力，提高病人的舒适性，改善病人就医感受。
1.5　数据收集与质量控制
1.5.1　数据收集
住院时长数据通过病历系统自动提取，确保数据的准确性和一致性。皮肤状态评估由2名经过专业培训的造口治疗师独立进行皮肤状态评估。生活质量问卷在病人出院前的24 h内完成，确保病人的恢复状态得到及时反映。
1.5.2　质量控制
1）操作标准化：为确保护理操作的统一性和一致性，制定了凸面底盘协同病人坐位造口护理标准操作程序。所有护理人员须通过视频考核，考核合格后方可进行操作。操作一致性通过Kappa值进行评估，要求Kappa≥0.85，以确保护理质量的标准化。2）数据完整性：设立独立的数据核查小组（数据收集2人不知晓两组病人分组及具体护理措施），负责每日对数据进行核查，确保数据收集的完整性与准确性。3）避免选择偏倚：采用中央随机系统进行组间随机分配，避免选择偏倚的影响，提高研究结果的科学性和可靠性。
1.6　统计学处理
采用SPSS 26.0和GraphPad Prism 9.0软件进行数据分析。符合正态分布的定量资料以均数±标准差（x±s）表示，采用t检验；不符合正态分布的定量资料以中位数（四分位数）[M(P25,P75)]表示，采用秩和检验。定性资料用例数、百分比（%）表示，采用χ2检验。所有统计检验均为双侧检验，以P<0.05为差异有统计学意义。
2　结果
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2.1　两组病人一般资料比较
研究期间对照组2例病人伤口与肠造口相邻且敷料覆盖影响造口底盘粘贴被剔除，1例病人术后突发脑出血，1例病人失访，最终对照组实际研究病人82例。观察组2例病人因术后放化疗未在本研究医院完成随访，最终纳入观察组病人84例。两组病人一般资料比较见表1。
2.2　两组病人主要结局指标比较（见表2）
2.3　两组病人次要结局指标比较（见表3）
2.4　两组病人生物力学指标比较（见表4）
3　讨论
收起
本研究结果显示，凸面底盘协同体位护理可以缩短病人住院时长，体现了该干预方案在卫生经济领域的潜在优势。程方方等[12]研究指出，肠造口病人每减少1 d住院时间可节省约15%的直接医疗成本，涵盖床位费用、护理耗材、药物与并发症处置等多项开支。
本研究结果显示，观察组病人肠造口术后并发症发生率明显降低，包括渗漏、刺激性皮炎和造口旁疝等，该效果可从生物力学角度进行解释。传统平面底盘在腹部曲面不均、体位变换频繁时易出现贴合不实、边缘翘起等问题，进而引发排泄物渗漏刺激皮肤[13]。本研究使用的凸面底盘设计在中心部位设有向内凸起的弧形区域，能够增强造口与底盘之间的负压贴合力，使粘贴界面在受力状态下更加稳定，有效减少造口液体的渗漏和剪切应力集中，从而保护皮肤完整性。研究指出，凸面底盘的广泛曲面贴合特性能将局部压力平均分布，减少因压力集中造成的组织缺血性坏死[14]。此外，配合坐位操作的标准化体位护理，如腹式呼吸配合支撑姿势，不仅保证了腹壁肌肉的张力适中，也有利于底盘在多角度运动状态下保持黏附。这一体位配合措施在先前研究中[15]并未被充分利用，而本研究通过定量压力监测进一步证实了其护理学价值。因此，凸面底盘联合坐位护理的协同策略不仅在结构力学层面实现对渗漏风险的前瞻控制，也在护理操作上形成了可高度复制的标准化操作方案，为造口并发症的综合防控提供了新思路。
本研究结果还显示，观察组Stoma-QOL各维度评分明显优于对照组。提示物理护理手段的创新不仅仅体现在并发症控制层面，对病人的心理适应与社会功能恢复更具有积极作用。薛静等[16]研究指出，造口病人术后常因形象受损与护理困难而产生社交回避行为，严重时甚至形成病耻感与抑郁倾向。而本研究中引入坐位训练与自我护理指导，使病人在术后早期即参与护理行为，通过规范训练建立起自我掌控感，有助于增强其自我效能感。这种主动参与式干预较被动接受护理模式更能促进病人心理恢复。张艳侠等[17]基于希望理论的研究亦发现，提升病人对自身恢复过程的积极认知是改善其社会互动能力的关键路径。本研究中的护理流程设计则通过整合造口结构优化与体位训练，将护理操作本身转化为“心理赋能”载体，促使病人在完成操作过程中建立自信。此外，改良后的凸面底盘在衣物遮盖下更为隐蔽，病人反馈中普遍提及其“更容易融入日常社交环境”，这一细节正是社会参与感提升的重要心理基础。因此，本研究所构建的多维护理干预模式，不仅改善了传统护理的局限性，也从躯体、心理、社会层面实现了生活质量的立体提升，提升病人就医感受。
此外，凸面底盘与体位护理相结合有效提升了底盘黏附稳定性，减少了更换频率与护理人力投入，间接降低医院资源使用密度，这一结果主要归功于新型材料与结构设计优化[18]。本研究持续结合远程随访、康复指导等后续干预手段，可构建起造口病人术后全周期、可持续的一体化护理管理闭环。齐琳娜等[19]研究提出，结合达标理论的照护路径虽能一定程度降低感染率，但在持续性与系统化管理方面仍欠缺。而本研究方案通过精准评估、标准操作、出院随访三位一体设计，在资源利用、费用控制与护理质量三者间实现了协同优化。
4　小结
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本研究基于凸面底盘与体位护理协同干预模式，系统评估了其在肠造口病人术后管理中的实际成效，结果表明该干预策略在缩短病人住院时长、降低造口并发症发生率、改善生活质量、提高病人满意度等方面均优于传统护理方法，具有良好的临床适用性。凸面底盘通过其独特的贴合结构优化了底盘-皮肤界面的生物力学性能，有效降低了渗漏及皮肤刺激的发生率[20]；体位护理干预则在提升底盘黏附强度的同时，增强了病人自我护理能力。两者协同作用，构建了一种集结构改良、行为指导与心理赋能于一体的综合护理模式。该方案在提高护理效率、节约医疗资源、优化病人体验方面亦展现出突出的卫生经济效益。未来仍需在多中心、大样本的临床实践中进一步验证该模式的长期疗效，并结合智能穿戴、生物材料及远程随访等手段，构建更加智能化、个体化的造口护理体系，推动护理服务向整体康复支持转型。

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doi: 10.12102/j.issn.1009-6493.2026.08.011
  • 接收时间：2025-06-04
  • 首发时间：2026-10-28
  • 出版时间：2026-04-25
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  • 收稿日期：2025-06-04
  • 修回日期：2026-04-03
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    1山西白求恩医院（山西医学科学院），山西医科大学第三医院，同济山西医院，山西 030032

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陈素清，副主任护师，硕士研究生，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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