陈绮琴?钟芳?张松?巫菊芳

[摘要] 目的 探讨循证护理在鼻咽癌患者放疗后口腔黏膜反应的应用效果。 方法 运用循证护理的方法共筛选出8篇文献并根据我院实际情况制定护理方案，将85例患者随机分为循证护理组43例，常规护理组42例，分别实施不同的护理方案并评价其护理效果。 结果 治疗7周后两组患者口腔黏膜反应程度有统计学意义，循证护理组患者放疗后口腔黏膜反应情况优于常规护理组，其持续时间较短，反应较轻，产生副作用更少，差异具有统计学意义（P<0.05）。 结论 应用循证医学方法制定的护理方案能够有效地减轻鼻咽癌放疗患者的口腔黏膜反应和痛苦，提高患者生活质量。

[关键词] 鼻咽癌；放疗；口腔黏膜炎；循证护理

[中图分类号] R473.73 [文献标识码] A [文章编号] 2095-0616（2017）09-81-03

Application of evidence based nursing in nasopharyngeal carcinoma patients with oral mucositis

CHEN Qiqin1 ZHONG Fang2 ZHANG Song1 WU Jufang1

1.Department of ENT，Guangming New District Peoples Hospital，Shenzhen 5188106，China；2.Department of ENT，Shenzhen Peoples Hospital，Shenzhen 518020，China

[Abstract] Objective To explore the application effect of evidence based nursing in nasopharyngeal carcinoma patients with oral mucositis. Methods Evidence based nursing was used to screen eight articles and the nursing plan was made according to the actual situation of our hospital.85 patients were randomly divided into evidence bases nursing group with 43 cases and routine nursing group with 42 cases.Different nursing plans were implemented， and their nursing effects were evaluated. Results After 7 weeks of treatment，there was significant difference in the degree of oral mucosa reaction between the two groups.The oral mucosa reaction of the patients in the evidence-based nursing group was better than that of the conventional nursing group，the duration was shorter，the reaction was mild，the side effects were fewer（P<0.05）. Conclusion Evidence based nursing can effectively reduce the oral mucosa reaction and pain，improve the quality of life of patients with nasopharyngeal carcinoma.

[Key words] Nasopharyngeal carcinoma；Radiotherapy；Oral mucositis；Evidence based nursing

作为常见的恶性肿瘤疾病之一，鼻咽癌的发病率较高。目前针对鼻咽癌的治疗方式多以放射治疗为主[1]。但是鼻咽癌患者在放疗治疗后会发生一些并发症，其中口腔黏膜炎症反应就是最常见的副作用之一。口腔黏膜反应的临床症状是味觉改变、唾液分泌降低以及溃疡等，容易导致患者发生进食困难和口腔疼痛等情况影响患者的正常生活[2]。循证护理（evidence based nursing，EBN）是以解决实际临床护理问题为出发点，用系统检索的方法来寻找现有的临床试验证据，并对其进行严格的质量评价和综合分析，最后提出解决方案，并进行方案实施，最后进行再评价的过程[3]。本研究针对鼻咽癌放疗后口腔黏膜炎的护理问题，应用循证护理的实施方法和步骤确定护理方案，选取85例鼻咽癌患者作为研究对象，对部分患者采取循证护理，以探