肿瘤患者免疫检查点抑制剂皮肤毒性管理智能体的构建与应用研究

doi:10.3761/j.issn.1672-9234.2026.08.015

中华护理教育 ›› 2026, Vol. 23 ›› Issue (8): 999-1007.doi: 10.3761/j.issn.1672-9234.2026.08.015

肿瘤患者免疫检查点抑制剂皮肤毒性管理智能体的构建与应用研究

朱燕丽¹^,^*(), 洪朝金¹, 樊莎莎², 沈竹青³, 赵梦琴¹, 谢李孩¹

¹ 杭州医学院附属浙江省人民医院肿瘤中心肿瘤内科杭州市 310014
² 杭州医学院附属浙江省人民医院整形修复外科中心皮肤科杭州市 310014
³ 杭州医学院附属浙江省人民医院信息化与人工智能部杭州市 310014

收稿日期:2025-12-28 出版日期:2026-08-15 发布日期:2026-08-14
通讯作者: *朱燕丽，女，本科，主管护师，E-mail：sunday091@163.com
作者简介:第一联系人：作者贡献声明
朱燕丽：研究设计、数据收集及整理、文章撰写；朱燕丽、洪朝金、赵梦琴：研究设计与实施、文章修订；樊莎莎、沈竹青、谢李孩：研究设计与实施。
基金资助:
浙江省医药卫生科技计划项目(2024KY744)

Design and implementation of an intelligent agent for managing immune checkpoint inhibitor-related skin toxicities in cancer patients

ZHU Yanli¹^,^*(), HONG Chaojin¹, FAN Shasha², SHEN Zhuqing³, ZHAO Mengqin¹, XIE Lihai¹

¹ Cancer Center， Department of Medical Oncology，Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital，Hangzhou Medical College)， Hangzhou 310014， China
² Center for Plastic & Reconstructive Surgery， Department of Dermatology，Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital，Hangzhou Medical College)， Hangzhou 310014， China
³ Department of Informatization and Artificial Intelligence， Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital，Hangzhou Medical College)， Hangzhou 310014， China

Received:2025-12-28 Online:2026-08-15 Published:2026-08-14
Contact: *ZHU Yanli，E-mail：sunday091@163.com
Supported by:
Zhejiang Provincial Medical and Health Science and Technology Program(2024KY744)

摘要/Abstract

摘要：

目的探讨肿瘤患者免疫检查点抑制剂皮肤毒性管理智能体的构建方法及应用效果。方法通过证据整合、患者访谈和专家函询形成肿瘤患者免疫检查点抑制剂皮肤毒性管理清单，以此为基础构建智能体。采用便利抽样法，选取浙江省某三级甲等医院肿瘤内科2025年1月—6月收治的146例接受免疫检查点抑制剂治疗的肿瘤患者作为研究对象，使用随机数字表将其分为试验组与对照组，每组73例。试验组在对照组的基础上依托智能体进行辅助管理。比较两组在干预前及干预第7、14、28天的皮肤毒性自我管理能力。结果皮肤毒性自我管理能力组间与时间存在交互效应（F_交互=201.08，P<0.001），简单效应分析显示，试验组在干预第7、14、28天自我管理水平均高于对照组（P<0.001）。结论该智能体构建过程规范，功能贴合临床需求，可为患者居家连续管理提供数字化支持，能够提升肿瘤患者免疫检查点抑制剂皮肤毒性的自我管理能力。

关键词: 肿瘤, 免疫检查点抑制剂, 皮肤毒性, 智能体, 护理

Abstract:

Objective To develop an intelligent agent for the management of immune checkpoint inhibitor-related skin toxicities in patients with cancer and evaluate its effectiveness in clinical practice. Methods A management checklist for immune checkpoint inhibitor-related skin toxicities in patients with cancer was developed through evidence synthesis，patient interviews，and expert panel discussions. Based on this checklist，an intelligent agent was constructed to support skin toxicity management. Using convenience sampling，146 patients with cancer receiving immune checkpoint inhibitor therapy who were admitted to the Department of Medical Oncology of a tertiary Grade A hospital in Zhejiang Province between January and June 2025 were enrolled. Participants were randomly assigned to either the intervention group or the control group using a random number table，with 73 patients in each group. Patients in the intervention group received intelligent agent-assisted management in addition to routine management provided to the control group. Skin toxicity self-management ability was assessed and compared between the two groups before the intervention and at days 7，14，and 28 of the intervention. Results There was a significant group-by-time interaction effect for skin toxicity self-management ability（F_interaction=201.08，P<0.001）. Simple effects analysis showed that self-management ability scores were significantly higher in the intervention group than in the control group at days 7，14，and 28 of the intervention（all P<0.001）. Conclusion The intelligent agent was developed through a rigorous process and aligned with clinical needs，providing digital support for continuous home-based management. It can improve the self-management ability of immune checkpoint inhibitor-related skin toxicities in patients with cancer.

Key words: Neoplasms, Immune Checkpoint Inhibitors, Skin Toxicity, Intelligent Agent, Nursing

朱燕丽, 洪朝金, 樊莎莎, 沈竹青, 赵梦琴, 谢李孩. 肿瘤患者免疫检查点抑制剂皮肤毒性管理智能体的构建与应用研究[J]. 中华护理教育, 2026, 23(8): 999-1007.

ZHU Yanli, HONG Chaojin, FAN Shasha, SHEN Zhuqing, ZHAO Mengqin, XIE Lihai. Design and implementation of an intelligent agent for managing immune checkpoint inhibitor-related skin toxicities in cancer patients[J]. Chinese Journal of Nursing Education, 2026, 23(8): 999-1007.

图/表 3

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肿瘤患者免疫检查点抑制剂皮肤毒性管理智能体的构建与应用研究

Design and implementation of an intelligent agent for managing immune checkpoint inhibitor-related skin toxicities in cancer patients

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