护理干预对老年糖尿病伴皮肤病溃疡患者的临床疗效分析
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摘要
为了探讨强化护理干预对老年糖尿病伴皮肤溃疡患者临床治疗效果的影响,现选取四川大学华西医院与南充市中心医院收治的110例糖尿病伴皮肤溃疡患者,采用随机数字表法分为强化组、对照组各55例,在给予相同的治疗方法的条件下,强化组给予针对性的溃疡护理方案,对照组仅给予常规护理;对比两组护理效果差异。结果显示强化组在治疗7 d、14 d及28 d时,创面愈合率显著高于对照组(p<0.05),强化组的溃疡完全愈合时间显著低于对照组患者(p<0.05);治疗7 d、14 d时,强化组患者创面TcPO2测定值显著高于对照组患者(p<0.05)。强化组治愈率为74.55%、好转率为25.45%,对照组治愈率为54.55%、好转率为43.64%、无效仅为1.82%,两组比较差异具有统计学意义(p<0.05)。表明对创面皮肤进行强化护理有利于促进老年糖尿病伴皮肤溃疡创面愈合,值得临床推广应用。
In order to explore the effect of intensive nursing intervention on the clinical treatment of senile diabetic patients with skin ulcers, now 110 patients with diabetes and skin ulcer treated West China hospital of sichuan university and central hospital of nanchong city were selected and divided into the intensive group and the control group with 55 cases in each group by random number table. Under the same treatment method conditions,the intensive group was given targeted ulcer care program, while the control group was given routine care only.The difference of the nursing effects of the two groups was compared. The results showed that the wound healing rate in the intensive group was significantly higher than that of the control group after 7 d, 14 d and 28 d of treatment(p<0.05). The complete healing time of ulcer in the intensive group was significantly lower than that of the control group(p<0.05). On the 7 th day and 14 th day of treatment, the test value of wound TcPO2 in the intensive group was significantly higher than that of the control group(p<0.05). In the intensive group, the cure rate was74.55% and the improvement rate was 25.45%. In the control group, the cure rate was 54.55%, the improvement rate was 43.64%, and the failure rate was only 1.82%. The difference between the two groups was statistically significant(p<0.05). It was indicated that intensive nursing of the wound skin would be beneficial to the healing of senile diabetes with skin ulcers, and it would be worthy of clinical application.
In order to explore the effect of intensive nursing intervention on the clinical treatment of senile diabetic patients with skin ulcers, now 110 patients with diabetes and skin ulcer treated West China hospital of sichuan university and central hospital of nanchong city were selected and divided into the intensive group and the control group with 55 cases in each group by random number table. Under the same treatment method conditions,the intensive group was given targeted ulcer care program, while the control group was given routine care only.The difference of the nursing effects of the two groups was compared. The results showed that the wound healing rate in the intensive group was significantly higher than that of the control group after 7 d, 14 d and 28 d of treatment(p<0.05). The complete healing time of ulcer in the intensive group was significantly lower than that of the control group(p<0.05). On the 7 th day and 14 th day of treatment, the test value of wound TcPO2 in the intensive group was significantly higher than that of the control group(p<0.05). In the intensive group, the cure rate was74.55% and the improvement rate was 25.45%. In the control group, the cure rate was 54.55%, the improvement rate was 43.64%, and the failure rate was only 1.82%. The difference between the two groups was statistically significant(p<0.05). It was indicated that intensive nursing of the wound skin would be beneficial to the healing of senile diabetes with skin ulcers, and it would be worthy of clinical application.
引文
Duvernoy C.S.,Raffel D.M.,Swanson S.D.,Jaiswal M.,Mueller G.,and Ibrahim E.S.,2016,Left ventricular metabolism,function,and sympathetic innervation in men and women with type 1 diabetes,Journal of Nuclear Cardiology,109(2):1-10
Fu X.X.,Huang H.,and Li Y.,2008,Clinical analysis of dermatic lesions in 154 diabetes patients,Zhongguo Redai Yixue(China Tropical Medicine),8(6):956-956(付晓雪,黄辉,李勇,2008,154例老年糖尿病患者皮肤病变的临床分析,中国热带医学,8(6):956-956)
Hu H.P.,and Chen M.W.,2016,Analysis of related factors of healing and amputation of diabetic foot ulcer,Anhui Yike Daxue Xuebao(Acta Universitatis Medicinalis Anhui),51(11):1634-1637(胡慧萍,陈明卫,2016,糖尿病足溃疡愈合及截肢的相关因素分析,安徽医科大学学报,51(11):1634-1637)
Hwang U.,Dresden S.W.,Rosenberg M.,Garrido M.,Loo G.,and Sze J.,2016,4 GEDI WISE:evaluation of the transitional care nurse intervention impact on hospital admissions from the emergency department,Annals of Emergency Medicine,68(4):S2
Liao Y.,2015,Epidemiology and research advances in diabetes mellitus in China,Chongqing Yike Daxue Xuebao(Journal of Chongqing Medical University),40(7):1042-1045(廖涌,2015,中国糖尿病的流行病学现状及展望,重庆医科大学学报,40(7):1042-1045)
Lv L.X.,Huang L.R.,Lao M.L.,Wang P.N.,Yu Z.H.,and Wei A.S.,2017,Nutritional status and its influencing factors in elderly patients with diabetic foot ulcers,Zhonghua Huli Zazhi(Chinese Journal of Nursing),52(3):332-335(吕丽雪,黄丽容,劳美铃,王甫能,誉昭红,魏爱生,2017,老年糖尿病足溃疡患者营养状况调查及其影响因素分析,中华护理杂志,52(3):332-335)
Pinto S.M.O.,2017,Comfort in palliative care:development and evaluation of a complex nursing intervention,Palliative Medicine,28(6):892
Que C.J.,and Jian S.Y.,2017,Correlation study on the change of chemerin level in serum fat factor and prognosis for diabetes patients,Xiandai Yiqi Yu Yiliao(Modern Instruments and Medical Treatment),23(4):70-72(阙朝锦,简守勇,2017,糖尿病患者血清脂肪因子Chemerin水平改变与临床预后的相关性研究,现代仪器与医疗,23(4):70-72)
Wang B.Y.,Niu G.M.,Du H.,and Weng L.X.,2016,Different wound dressings in the treatment of diabetic foot ulcers,Zhongguo Zuzhi Gongcheng Yanjiu(Chinese Journal of Tissue Engineering Research),20(34):5155-5162(王冰洋,牛广明,杜华,翁立新,2016,不同敷料在糖尿病足溃疡伤口治疗中的研究与应用,中国组织工程研究,20(34):5155-5162)
Wang G.F.,Xu N.,and Yang T.,2017,Transcutaneous oxygen pressure andits clinical significance in patients with type 2diabetic peripheral neuropathy,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),25(9):822-826(王国凤,徐宁,杨涛,2017,经皮氧分压在2型糖尿病周围神经病变中的变化及其临床意义,中国糖尿病杂志,25(9):822-826)
Yan Y.F.,Hou H.R.,Yang J.,Liu Z.Y.,Liu J.,and Zhou L.,2012,Effects of alternating wet and dry healing technology in elderly diabetic patients with multiple skin lesions,Zhonghua Huli Zazhi(Chinese Journal of Nursing),47(9):788-789(闫雅凤,侯惠如,杨晶,刘志英,刘晋,周琳,2012,两种愈合技术用于老年糖尿病多发皮肤病变的效果分析,中华护理杂志,47(9):788-789)
Yuan Y.H.,2015,Analysis of the effect of the whole nursing intervention in compliance and quality of life of diabetic patients,Dajia Jiankang(Healthy People),9(19):15-16(袁玉辉,2015,全程护理干预对提高中老年糖尿病患者依从性及生活质量的效果分析,大家健康,9(19):15-16)
Zhang C.,Zeng Y.M.,and Liu K.,2016,Analysis of pre-hospital delay and its influencing factors in patients with diabetic foot,Zhonghua Huli Zazhi(Chinese Journal of Nursing),51(5):567-572(张苍,曾咏梅,刘可,2016,糖尿病足患者就诊延迟现状及其影响因素分析,中华护理杂志,51(5):567-572)
Zhu P.,Ren M.,Xu G.,Chen B.,Lao G.C.,and Ran J.M.,2013,The association and interaction of diabetic peripheral neuropathy and peripheral arterial disease with diabetic foot ulcers,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),21(12):1074-1077(朱平,任萌,徐刚,陈宾,劳干诚,冉建民,2013,糖尿病周围神经病变和血管病变对糖尿病足溃疡的相互作用及相关性探讨,中国糖尿病杂志,21(12):1074-1077)
Zhu W.B.,2016,Research progress of the mechanism and treatment of diabetic non-healing wounds,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),24(12):1135-1139(朱万博,2016,糖尿病患者创面难愈机制及治疗研究进展,中国糖尿病杂志,24(12):1135-1139)
Fu X.X.,Huang H.,and Li Y.,2008,Clinical analysis of dermatic lesions in 154 diabetes patients,Zhongguo Redai Yixue(China Tropical Medicine),8(6):956-956(付晓雪,黄辉,李勇,2008,154例老年糖尿病患者皮肤病变的临床分析,中国热带医学,8(6):956-956)
Hu H.P.,and Chen M.W.,2016,Analysis of related factors of healing and amputation of diabetic foot ulcer,Anhui Yike Daxue Xuebao(Acta Universitatis Medicinalis Anhui),51(11):1634-1637(胡慧萍,陈明卫,2016,糖尿病足溃疡愈合及截肢的相关因素分析,安徽医科大学学报,51(11):1634-1637)
Hwang U.,Dresden S.W.,Rosenberg M.,Garrido M.,Loo G.,and Sze J.,2016,4 GEDI WISE:evaluation of the transitional care nurse intervention impact on hospital admissions from the emergency department,Annals of Emergency Medicine,68(4):S2
Liao Y.,2015,Epidemiology and research advances in diabetes mellitus in China,Chongqing Yike Daxue Xuebao(Journal of Chongqing Medical University),40(7):1042-1045(廖涌,2015,中国糖尿病的流行病学现状及展望,重庆医科大学学报,40(7):1042-1045)
Lv L.X.,Huang L.R.,Lao M.L.,Wang P.N.,Yu Z.H.,and Wei A.S.,2017,Nutritional status and its influencing factors in elderly patients with diabetic foot ulcers,Zhonghua Huli Zazhi(Chinese Journal of Nursing),52(3):332-335(吕丽雪,黄丽容,劳美铃,王甫能,誉昭红,魏爱生,2017,老年糖尿病足溃疡患者营养状况调查及其影响因素分析,中华护理杂志,52(3):332-335)
Pinto S.M.O.,2017,Comfort in palliative care:development and evaluation of a complex nursing intervention,Palliative Medicine,28(6):892
Que C.J.,and Jian S.Y.,2017,Correlation study on the change of chemerin level in serum fat factor and prognosis for diabetes patients,Xiandai Yiqi Yu Yiliao(Modern Instruments and Medical Treatment),23(4):70-72(阙朝锦,简守勇,2017,糖尿病患者血清脂肪因子Chemerin水平改变与临床预后的相关性研究,现代仪器与医疗,23(4):70-72)
Wang B.Y.,Niu G.M.,Du H.,and Weng L.X.,2016,Different wound dressings in the treatment of diabetic foot ulcers,Zhongguo Zuzhi Gongcheng Yanjiu(Chinese Journal of Tissue Engineering Research),20(34):5155-5162(王冰洋,牛广明,杜华,翁立新,2016,不同敷料在糖尿病足溃疡伤口治疗中的研究与应用,中国组织工程研究,20(34):5155-5162)
Wang G.F.,Xu N.,and Yang T.,2017,Transcutaneous oxygen pressure andits clinical significance in patients with type 2diabetic peripheral neuropathy,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),25(9):822-826(王国凤,徐宁,杨涛,2017,经皮氧分压在2型糖尿病周围神经病变中的变化及其临床意义,中国糖尿病杂志,25(9):822-826)
Yan Y.F.,Hou H.R.,Yang J.,Liu Z.Y.,Liu J.,and Zhou L.,2012,Effects of alternating wet and dry healing technology in elderly diabetic patients with multiple skin lesions,Zhonghua Huli Zazhi(Chinese Journal of Nursing),47(9):788-789(闫雅凤,侯惠如,杨晶,刘志英,刘晋,周琳,2012,两种愈合技术用于老年糖尿病多发皮肤病变的效果分析,中华护理杂志,47(9):788-789)
Yuan Y.H.,2015,Analysis of the effect of the whole nursing intervention in compliance and quality of life of diabetic patients,Dajia Jiankang(Healthy People),9(19):15-16(袁玉辉,2015,全程护理干预对提高中老年糖尿病患者依从性及生活质量的效果分析,大家健康,9(19):15-16)
Zhang C.,Zeng Y.M.,and Liu K.,2016,Analysis of pre-hospital delay and its influencing factors in patients with diabetic foot,Zhonghua Huli Zazhi(Chinese Journal of Nursing),51(5):567-572(张苍,曾咏梅,刘可,2016,糖尿病足患者就诊延迟现状及其影响因素分析,中华护理杂志,51(5):567-572)
Zhu P.,Ren M.,Xu G.,Chen B.,Lao G.C.,and Ran J.M.,2013,The association and interaction of diabetic peripheral neuropathy and peripheral arterial disease with diabetic foot ulcers,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),21(12):1074-1077(朱平,任萌,徐刚,陈宾,劳干诚,冉建民,2013,糖尿病周围神经病变和血管病变对糖尿病足溃疡的相互作用及相关性探讨,中国糖尿病杂志,21(12):1074-1077)
Zhu W.B.,2016,Research progress of the mechanism and treatment of diabetic non-healing wounds,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),24(12):1135-1139(朱万博,2016,糖尿病患者创面难愈机制及治疗研究进展,中国糖尿病杂志,24(12):1135-1139)