循证护理对膀胱全切原位回肠代膀胱术患者尿瘘防治及生活质量的影响

[摘要] Abstract：Objective To investigate the effect of evidencebased nursing on prevention of urinary fistula and quality of life in patients with total cystectomy and orthotopic ileal neobladder replacement surgery. Methods A total of 22 patients with treatment of total cystectomy and orthotopic ileal neobladder replacement surgery from June 2012 to May 2013 were recruited as control group, and another 19 patients with same treatment from June 2013 to May 2014 were included as study group. The control group was given conventional nursing and the study group was applied with evidencebased nursing, respectively. The incidence of urinary fistula in 1 week after intervention and quality of life assessed by EORTC QLQC30 were compared between two groups. Results The incidence of urinary fistula was 5.3% in study group and was 31.8% in control group, with a significant difference (P<0.05). The average fistula healing time was lower in study group than that of control group ［(36.6±5.3) h vs. (83.5±10.9) h, P<0.05］. Overall quality of life, physical function, role function, emotional function, cognition function and social function in the study group were significantly higher compared with the control group in 6 weeks after intervention (P<0.05 or P<0.01). Conclusion Evidencebased nursing is more effective to reduce the risk of urinary fistula and to improve the quality of life in patients after receiving total cystectomy and orthotopic ileal neobladder replacement surgery.

[学科分类] 护理学

[关键词] 原位回肠代膀胱术;循证护理;生活质量;尿瘘