陈莉 魏军

[摘要]目的探讨循证理论指导下优化护理策略对尿路造口患者并发症发生率的影响。方法选取2019年2月至2021年2月在武汉科技大学附属天佑医院确诊的84例腹壁尿路造口患者，采用简单随机分组将患者分为观察组和对照组，每组各42例。对照组患者采用常规护理进行干预，观察组采用循证理论指导下优化护理策略进行干预，均持續干预14 d，在干预结束后1个月进行随访。在护理干预前后，采用世界卫生组织生活质量测定量表（WHOQOL-100）评估两组患者的生活质量，采用自我护理能力测定量表（ESCA）评估两组患者的自我护理能力，观察两组患者在护理期间并发症的发生率。结果观察组生理健康、心理状态、独立能力和社会关系等 WHOQOL-100评分均显著高于对照组（ P <0.05）;观察组自我护理技能、自护责任感、自我概念和健康知识水平等 ESCA 评分显著高于对照组（ P <0.05）;观察组患者并发症总发生率为7.14%，显著低于对照组的23.81%（ P <0.05）。结论循证理论指导下优化护理策略可以降低尿路造口患者的并发症，提高生活质量和自我护理能力。

[关键词]循证理论指导;优化护理;尿路造口;并发症

[中图分类号] R473  [文献标识码] A   [文章编号]2095-0616（2021）23-0135-04

The effect of optimized nursing strategy under the guidance of evidence-based theory on the incidence of complications in the patients with urinary tract stoma

CHEN  Li    WEI  Jun

Department of Urology， Tianyou Hospital Affiliated to Wuhan University of Science and Technology， Hubei， Wuhan 430064， China

[Abstract] Objective To explore the effect of optimized nursing strategy under the guidance of evidence-based theory on the incidence of complications in the patients with urinary tract stoma. Methods A total of 84 patients with urinary tract stoma on the abdominal wall diagnosed in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from February 2019 to February 2021 were selected and divided into the observation group and the control group through simple random grouping， with 42 patients in each group. The patients in the control group were intervened by conventional nursing， while those in the observation group were intervened by optimized nursing strategy under the guidance of evidence- based theory， both of which lasted for 14 d. The patients were followed up 1 month after the intervention ended. Before and after nursing intervention， the World Health Organization Quality of Life Scale （WHOQOL-100） was used to evaluate the quality of life of the two groups of patients， the Exercise of Self-care Agency Scale （ESCA） was used to evaluate the self- care ability of the two groups of patients， and the incidence of complications in the two groups of patients during nursing was observed. Results The WHOQOL-100 scores of physiological health， psychological state， independent ability and social relations， etc， of the observation group were all significantly higher than those of the control group （P <0.05）. The ESCA scores of self-care skills， self-care sense of responsibility， self-concept and health knowledge level， etc， of the observation group were significantly higher than those of the control group （P <0.05）. The total incidence of complications in the patients of the observation group was 7.14%， which was significantly lower than the 23.81% of the control group （P <0.05）. Conclusion Optimized nursing strategy under the guidance of evidence-based theory can reduce the complications of the patients with urinary tract stoma and improve their quality of life and self-care ability.

[Key words] The guidance of evidence-based theory; Optimized nursing; Urinary tract stoma; Complications

尿路造口是指在手术过程中，将两条輸尿管的末端缝合在游离的一段回肠上，这段回肠的一端被缝合，另一端则缝于腹部的一个开口，用于排泄尿液。尿路造口将原本的排尿习惯改变，需要患者长时间的佩戴尿路造口袋，给患者的生活和心理造成极大的影响[1，2]。而且尿路造口术后常会发生尿路狭窄、尿路造口周围皮肤刺激性皮炎等并发症，不利于患者的预后[3]。既往研究显示，对尿路造口患者给予一定的护理干预措施有利于降低并发症的发生风险[4]，改善预后。循证理论指导下优化护理策略是通过搜索各种资料文献总结相关经验，从而制订以患者需求为基础的护理方案[5]，可提高患者的生活质量，改善心理焦虑状态。……