探讨机器人辅助腹腔镜前列腺根治性切除术后合并直肠瘘、腹腔感染、尿道吻合口瘘、双小腿肌间静脉血栓、造口皮肤黏膜分离等多种并发症的护理经验。

回顾性分析1例机器人辅助腹腔镜前列腺根治性切除术后合并多种并发症患者的临床资料。患者于2023年8月18日确诊前列腺癌，于9月27日行机器人辅助腹腔镜前列腺根治性切除术，术后第3日出现直肠瘘，并合并腹腔感染，术后第6日出现尿道吻合口瘘，随后合并双小腿肌间静脉血栓（急性期）及造口皮肤黏膜分离。护理要点包括密切观察患者腹腔引流液、体温等病情变化，警惕并发症发生，积极溶栓及进行下肢深静脉血栓护理，及时评估患者营养状态，并制定个体化的营养方案，进行全程规范化的造口护理，实施个性化的心理护理，以保障患者身心健康。

患者于术后37 d康复出院，术后3个月复查示双下肢静脉血栓机化，造口功能良好，白蛋白38.6 g/L。

前列腺根治手术创伤大、操作复杂，易发生并发症，对于合并多种并发症且病情复杂的患者需医护严密观察病情变化，并坚持多学科诊治，整合多学科优势，制定个体化治疗方案，从而让患者最大化长期获益。

To investigate the nursing experience of postoperative complications such as rectal fistula, peritoneal infection, urethral anastomotic fistula, intermuscular venous thrombosis of both legs, separation of skin and mucosa after radical prostatectomy with robot-assisted laparoscopy.

The clinical data of a patient with multiple complications after radical robot-assisted laparoscopic prostatectomy were retrospectively analyzed. The patient was diagnosed with prostate cancer on August 18, 2023, and underwent robot-assisted laparoscopic radical prostatectomy on September 27, 2023. Rectal fistula occurred on the 3rd day after surgery, complicated with abdominal infection, urethral anastomotic fistula on the 6th day after surgery, followed by intramuscular venous thrombosis of both legs (acute stage) and separation of the skin and mucosa of the stoma. Nursing points include close observation of patients' abdominal drainage, body temperature and other changes, alert to complications, active thrombolysis and lower limb deep vein thrombosis care, timely assessment of patients' nutritional status, and formulation of individualized nutrition programs, standardized stoma care throughout the whole process, personalized psychological care, in order to ensure patients' physical and mental health.

The patient recovered and was discharged 37 days after surgery. Three months after surgery, a follow-up examination showed that the venous thrombosis in both lower limbs was organized, the stoma function was good, and the albumin level was 38.6g/L.

Radical prostatectomy is traumatic, complicated and prone to complications. For patients with multiple complications and complicated conditions, medical care should closely observe the changes of the condition, adhere to multidisciplinary diagnosis and treatment, integrate the advantages of multiple disciplines, and formulate an individualized treatment plan, so as to maximize the long-term benefits of patients.