目的 为鼻咽癌放化疗患者制订有效防护口腔黏膜炎的循证护理方案.方法 提出临床问题并建立循证护理团队,检索Best practice、美国指南网、JBI数据库、Cochrane图书馆、CINAHL、PubMed、Embase、中国知网、万方数据库和中国生物医学文献数据库关于放化疗所致口腔黏膜炎的相关文献,进行文献质量评价,形成循证防护策略后,培训相关人员,将证据应用于临床实践.比较循证护理实施前后患者口腔黏膜炎症状等级、口腔黏膜疼痛程度及放化疗前后体质量差值.结果 经循证实践,形成了7项鼻咽癌放化疗患者口腔黏膜炎防护策略.经统计,实施循证干预后患者口腔黏膜炎症状等级、疼痛程度、放化疗期间体质量丢失量均优于实施前,差异有统计学意义(P＜0.05).结论 循证护理实践可促进护理人员科研证据意识的培养和参与积极性,提升了同步放化疗鼻咽癌患者照护质量和临床护理工作的有效率,改变了口腔黏膜炎的传统护理模式.%Objective To establish an evidence-based nursing plan for effective protection of oral mucositis in patients with radiotherapy and chemotherapy for nasopharyngeal carcinoma. Methods Clinical questions were raised and evidence-based nursing teams were established. Relevant literatures on oral mucositis caused by radiotherapy or chemotherapy were retrieved from Best Practice, NGC, JBI, Cochrane Library, CINAHL, PubMed, Embase, China Knowledge Network, Wanfang Database, and China Biomedical Literature Database. We assessed the quality of the included literatures then formed evidence-based protection strategies. After the training of relevant personnel, the strategies were implemented in clinical practice. The grades of oral mucositis, the scores of oral mucosal pain and weight difference after radiotherapy and chemotherapy were compared between the two groups. Results We formed 7 evidence-based nursing practice strategies and they were effective for reducing the grade of oral mucositis, the degree of pain in patients with oral cavity, and the weight loss of patients during radiotherapy and chemotherapy and the difference was statistically significant (P＜0.05). Conclusion Evidence-based nursing practice can promote the awareness of scientific evidence and the enthusiasm of nurses, improve nursing quality and the effectiveness of clinical nursing work, and change the traditional nursing model of oral mucositis.
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