膀胱全切原位回肠代膀胱术后尿瘘的循证护理

目的探讨循证护理在防治膀胱全切原位回肠代膀胱术后尿瘘中的应用效果。方法60例患者按随机数字表法随机分为观察组（n=30）和对照组（n=30），对照组实施常规护理，观察组实行循证护理，首先成立循证护理小组，根据临床护理经验，提出循证问题，进行文献检索，获取循证支持，根据查询实证制订护理措施应用于临床。结果观察组患者无一例发生尿瘘，对照组尿瘘发生率16．67％，两组比较差异具有统计学意义（X^2=5．45，P〈0．05）；观察组EORTCQLQ—C30总体生活质量及各因子得分均明显高于对照组，其中观察组护理后总体生活质量得分为（74．13±11．32）分，对照组为（61．56±11．24）分，组间比较差异有统计学意义（t=19．548，P〈0．05）。结论循证护理可有效预防膀胱全切原位回肠代膀胱术后尿瘘的发生，提高患者生活质量，值得临床推广。

Evidence-based nursing on urinary fistula after total cystectomy with ileal orthotopic neobladder

Objective To explore the effect of evidence-based nursing on urinary fistula after total cysteetomy with ileal orthotopie neobladder. Methods 60 patients were divided into observation and control group （30 in each group）; control group was treated with regular nursing, and observation group was treated with evidence-based nursing： first establishing evidence-based nursing group; propose evidence-based problem according the experience of nursing; then literature searching and obtaining support of evidence; application on the clinical. Results No urinary fistula occurred in the observation group, and the occurring rate was 16.67% in the control group, and the difference was significant （ ~2 = 5.45,P 〈 0. 05） ; total life quality of EORTCQLQ-C30 and other factors in observation group were higher than those in the contl＂ol group, including（74. 13 ＋ 11.32）in observation group and （61.56 ＋ 11.24） in control group, and the difference was significant （t = 19. 548,P 〈 0. 05）. Conclusions Evidence-based nursing could prevent the urinary fistula after total cysteetomy with ileal orthotopie neobladder, and improve the life quality and worth application in clinic.