摘要目的:探讨基于协同理论的多级联动护理管理体系在输尿管皮肤造口患者中的应用。方法:采取便利抽样法，选取2024年5月1日至2024年7月1日就诊于南昌大学第一附属医院伤口造口门诊和住院部的104例输尿管皮肤造口术患者作为研究对象，根据随机数字表法分为对照组和干预组，各52例，对照组接受常规护理方案，干预组在此基础上采用基于协同理论的多级联动护理管理模式。采用输尿管造口患者自我管理量表、中文版造口患者生活质量量表(C-COH)、造口自我效能量表(SSES)、赫氏希望量表(HHI)分别于患者就诊当天、1个月、2个月、3个月后评估两组患者自我管理、生活质量、自我效能和希望水平，并比较两组3个月内造口并发症的发生率。结果:3个月内干预组患者并发症发生率低于对照组( P<0.05)；经重复测量方差分析显示，干预组在自我管理能力、生活质量、自我效能以及希望水平方面的评分高于对照组，差异具有统计学意义( P<0.05)，且均存在时间效应、组间效应及交互效应。 结论:将协同理论与"互联网＋"技术结合，构建了动态化的多级护理网络，解决了传统模式中资源分散、信息孤岛的问题。通过多级联动护理管理模式提升输尿管皮肤造口患者自我管理、生活质量、自我效能和希望水平，降低患者的并发症发生率，促进优质资源下沉基层，协同各级医疗机构同质化发展，为患者提供了更高效、便捷的护理服务。

abstractsObjective:To explore the application of the multi-level linkage nursing management system based on synergy theory in patients with ureteral cutaneous stoma.Methods:By using the convenience sampling method, 104 patients who underwent ureterostomy and were treated at the stoma outpatient and inpatients department of the First Affiliated Hospital of Nanchang University from May 1, 2024 to July 1, 2024 were selected as the research subjects. According to the random number table method, the patients were divided into the control group and the intervention group, with 52 cases in each group.The control group received the conventional nursing plan, while the intervention group adopted a multi-level linkage nursing management model based on the synergy theory on this basis.The Cutaneous Ureterostomy Patient Self-management Scale, the City of Hope-Quality of Life-Ostomy Questionnaire-Chinese Version (C-COH), the Stoma Self-Efficacy Scale (SSES), and the Herth Hope Scale (HHI) were used to evaluate the self-management, quality of life, self-efficacy, and hope levels of the two groups of patients on the day of their visit, 1 month, 2 months, and 3 months later, respectively. The incidence of stoma complications within 3 months between the two groups were compared.Results:The incidence of complications in the intervention group was lower than that in the control group within 3 months ( P<0.05). Repeated measures analysis of variance showed that the scores of the intervention group in self-management ability, quality of life, self-efficacy and hope level were higher than those of the control group, and the differences were statistically significant ( P<0.05), and there were time effects, intergroup effects and interaction effects. Conclusions:By integrating the collaborative theory with " Internet + " technology, a dynamic multi-level nursing network has been constructed, solving the problems of scattered resources and information silos in the traditional model. Through the multi-level linkage nursing management model, the self-management, quality of life, self-efficacy and hope level of patients with ureterostomy have been enhanced, the incidence of complications among patients has been reduced, high-quality resources have been promoted to the grassroots level, and the homogeneous development of medical institutions at all levels has been coordinated, providing patients with more efficient and convenient nursing services.