循证护理实践在降低喉切除患者咽瘘发生率中的应用  

Application of evidence-based nursing practice on reducing the incidence of pharyngo-cutancous fistula among laryngectomy patients

作　　者：田梓蓉[1] 黄志刚[2] 张平[2] 梁晶[2] 肖克珍[2] 房居高[2] 南方[2] 李莉[2] 何云[2] 龙海欣[2] Tian Zirong;Huang Zhigang;Zhang Ping;Liang Jing;Xiao Kezhen;Fang Jugao;Nan Fang;Li Li;He Yun;Long Haixin(Nursing Department,Beifing Tongren Hospital,Capital Medical University,Beijing 100730,China;Otolaryngology and Head and Neck Surgery,Beifing Tongren Hospital,Capital Medical University,Beifing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院护理部,北京100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730

出　　处：《中华现代护理杂志》2018年第26期3104-3108,共5页Chinese Journal of Modern Nursing

基　　金：北京市医院管理局“青苗”人才计划科研项目（QML20160204）

摘　　要：目的 探讨循证护理实践在降低喉切除患者咽瘘的发生率、减少术后住院时间、减轻患者经济负担方面的应用效果.方法 选择2017年6月—2018年3月在北京同仁医院行喉切除术患者为研究对象,按照患者入院的先后顺序预先编号,并按随机数字表法随机分为两组,对照组51例,采用常规护理,试验组50例,在常规护理的同时采用约翰霍普金斯循证护理实践模型（JHNEBP）,将证据转化为护理方案,实施并评价护理效果.观察两组患者的咽瘘发生率和术后住院天数.结果 试验组患者咽瘘发生率10.00％,对照组27.45％,差异有统计学意义（χ2=5.034,P=0.025）;试验组患者术后住院天数（12.78±3.99）d,对照组（17.22±6.45）d,差异有统计学意义（t=-4.151,P〈0.001）.结论 采用JHNEBP制定的循证护理实践方案可以降低喉切除患者咽瘘的发生率,缩短术后住院时间.Objective To explore the effects of evidence-based nursing practice on reducing the incidence of pharyngo-cutancous fistula, shortening hospital day after surgery and easing the financial burden among laryngectomy patients.Methods From June 2017 to March 2018, we selected laryngectomy patients as subjects in Beijing Tongren Hospital. Patients were numbered according to the order being admitted to hospital and randomly divided into two groups with the random number table. Control group （n=51） received routine nursing. Experimental group （n=50） carried out routine nursing along with transforming evidence into nursing plan, implementing and evaluating nursing care effects by the Johns Hopkins nursing evidence-based practice （JHNEBP） model. We observed the incidence of pharyngo-cutancous fistula and hospital stay of patients between two groups.Results The incidence of pharyngeal fistula of experimental group and control group were 10.00 % and 27.45% respectively with a significant difference （χ2=5.034,P=0.025）. The hospital day of experimental group and control group were （12.78±3.99）d and （17.22±6.45）d respectively with a significant difference （t= -4.151,P〈0.001）.Conclusions The evidence-based nursing practice based on JHNEBP can reduce the incidence of pharyngo-cutancous fistula and shorten hospital day after surgery.

关 键 词：喉切除术 循证护理 喉肿瘤 咽瘘 

分 类 号：R473.73[医药卫生—护理学] R-03[医药卫生—临床医学]