本院近三年糖尿病足筛查情况及综合护理干预措施对糖尿病足发生率的影响分析(1)
【摘要】 目的：探讨糖尿病足筛查情况及综合护理干预对糖尿病足发生率的影响。方法：选取2014年6月-2017年6月本院收治的356例糖尿病患者进行糖尿病足危险因素筛查，按随机数字表法分为两组，每组各178例。对照组行常规护理，观察组在对照组基础上实施综合护理干预，比较两组护理干预后糖尿病足发生情况及护理满意度。结果：356例糖尿病患者中，187例(52.63%)发生周围神经病变，92例(25.84%)发生不同程度的血管病变，77例(21.63%)既发生周围神经病变又发生血管病变。其中观察组干预后糖尿病足发生率低于对照组，护理满意度高于对照组(P<0.05)。结论：糖尿病患者发生糖尿病足的危险性较高，通过加强糖尿病足的筛查，并配合综合护理干预措施的开展，能有效预防糖尿病足发生。
【关键词】 糖尿病足; 危险因素筛查; 综合护理
【Abstract】 Objective：To investigate the screening of diabetic foot and the effect of comprehensive nursing intervention on the incidence of it.Method：A total of 356 diabetic patients admitted in our hospital from June 2014 to June 2017 were screened for risk factors of diabetic foot.According to the random number table method，all patients were divided into two groups，178 cases in each group.The control group was given routine nursing，and the observation group was given comprehensive nursing intervention based on the control group.The incidence of diabetes mellitus and nursing satisfaction were compared between the two groups.Result：Among the 356 cases of diabetic patients，there were 187 cases(52.63%)of peripheral neuropathy，92 cases(25.84%)of different degrees of vascular lesions，77 cases(21.63%)of peripheral neuropathy combined with vascular lesions.After the intervention，the prognosis of diabetic foot in the observation group was lower than that in the control group，and the satisfaction degree of the nursing was higher than that of the control group(P<0.05).Conclusion：Diabetes mellitus has a high risk of diabetic foot，and it can effectively prevent the occurrence of diabetic foot by strengthening the screening of diabetic foot and cooperating with comprehensive nursing intervention.
【Key words】 Diabetic foot; Risk factor screening; Comprehensive nursing
First-author’s address：Shaoguan First People’s Hospital，Shaoguan 512000，China
doi：10.3969/j.issn.1674-4985.2019.04.028
糖尿病是临床常见的慢性代谢性疾病，随着近年生活节奏的加快，以及饮食习惯的改变，糖尿病的发病人数逐渐增加，使得糖尿病足发病率显著提高。有研究表明，糖尿病患者中20%～25%会发展成糖尿病足[1]。糖尿病足治疗复杂，难度较大，是造成非创伤性截肢的第一原因。本研究运用糖尿病足病筛查仪进行筛查早期发现糖尿病高危足，并运用综合护理干预措施预防糖尿病足病的发生，以篩查后未干预的糖尿病高危足患者为对照，比较1年后两组糖尿病足病发生率的差异，为护理干预预防糖尿病足病的发生提供依据，现报道如下。
1 资料与方法
1.1 一般资料 选取2014年6月-2017年6月本院收治的糖尿病患者356例，按随机数字表法分为两组，每组各178例。对照组行常规护理，观察组在对照组基础上实施综合护理干预。纳入标准：均进行糖尿病足筛查;经检查空腹血糖≥7.0 mmol/L，或餐后2 h血糖≥11.1 mmol/L;所选患者均同意本次研究，均签署知情同意书，经医院伦理学委员会批准[2]。排除标准：合并心肌炎、心肌梗死、脑梗死等疾病者;腰椎间盘突出症者;慢性阻塞性肺疾病者;肝肾功能不全者;资料不全或中途退出者。
1.2 方法
1.2.1 糖尿病足筛查 所有患者首先进行足部局部检查，测定双下肢、足背部皮肤体温，观察皮肤颜色变化;趾甲有无异常;左右前足掌、足后跟、足内外侧、趾尖有无胼胝;足背动脉搏动情况;双下肢有无感染、溃疡或坏疽，以及双下肢有无感觉异常。随后行足部感觉神经功能检查，使用10 g尼龙丝进行触觉、痛觉检查，检查时应避免溃疡或胼胝处，并于双足第一趾骨关节头进行VPT震动感觉阈值检查，同一部位只能重复检查2次，最后行四肢多普勒血流图检查，检查部位包括足背动脉、肱动脉、颈动脉等，计算公式，踝肱指数(ABI)=踝部血压/上臂血压，正常：ABI正常范围0.9～1.3;轻度血管病变：ABI≤0.71～0.90;中度血管病变：ABI≤0.41～0.70;重度血管病变：ABI≤0.40;ABI>1.31时，则提示血管显著钙化[3]。, http://www.100md.com(刘苑清 邓国宝 刘阳优)
【关键词】 糖尿病足; 危险因素筛查; 综合护理
【Abstract】 Objective：To investigate the screening of diabetic foot and the effect of comprehensive nursing intervention on the incidence of it.Method：A total of 356 diabetic patients admitted in our hospital from June 2014 to June 2017 were screened for risk factors of diabetic foot.According to the random number table method，all patients were divided into two groups，178 cases in each group.The control group was given routine nursing，and the observation group was given comprehensive nursing intervention based on the control group.The incidence of diabetes mellitus and nursing satisfaction were compared between the two groups.Result：Among the 356 cases of diabetic patients，there were 187 cases(52.63%)of peripheral neuropathy，92 cases(25.84%)of different degrees of vascular lesions，77 cases(21.63%)of peripheral neuropathy combined with vascular lesions.After the intervention，the prognosis of diabetic foot in the observation group was lower than that in the control group，and the satisfaction degree of the nursing was higher than that of the control group(P<0.05).Conclusion：Diabetes mellitus has a high risk of diabetic foot，and it can effectively prevent the occurrence of diabetic foot by strengthening the screening of diabetic foot and cooperating with comprehensive nursing intervention.
【Key words】 Diabetic foot; Risk factor screening; Comprehensive nursing
First-author’s address：Shaoguan First People’s Hospital，Shaoguan 512000，China
doi：10.3969/j.issn.1674-4985.2019.04.028
糖尿病是临床常见的慢性代谢性疾病，随着近年生活节奏的加快，以及饮食习惯的改变，糖尿病的发病人数逐渐增加，使得糖尿病足发病率显著提高。有研究表明，糖尿病患者中20%～25%会发展成糖尿病足[1]。糖尿病足治疗复杂，难度较大，是造成非创伤性截肢的第一原因。本研究运用糖尿病足病筛查仪进行筛查早期发现糖尿病高危足，并运用综合护理干预措施预防糖尿病足病的发生，以篩查后未干预的糖尿病高危足患者为对照，比较1年后两组糖尿病足病发生率的差异，为护理干预预防糖尿病足病的发生提供依据，现报道如下。
1 资料与方法
1.1 一般资料 选取2014年6月-2017年6月本院收治的糖尿病患者356例，按随机数字表法分为两组，每组各178例。对照组行常规护理，观察组在对照组基础上实施综合护理干预。纳入标准：均进行糖尿病足筛查;经检查空腹血糖≥7.0 mmol/L，或餐后2 h血糖≥11.1 mmol/L;所选患者均同意本次研究，均签署知情同意书，经医院伦理学委员会批准[2]。排除标准：合并心肌炎、心肌梗死、脑梗死等疾病者;腰椎间盘突出症者;慢性阻塞性肺疾病者;肝肾功能不全者;资料不全或中途退出者。
1.2 方法
1.2.1 糖尿病足筛查 所有患者首先进行足部局部检查，测定双下肢、足背部皮肤体温，观察皮肤颜色变化;趾甲有无异常;左右前足掌、足后跟、足内外侧、趾尖有无胼胝;足背动脉搏动情况;双下肢有无感染、溃疡或坏疽，以及双下肢有无感觉异常。随后行足部感觉神经功能检查，使用10 g尼龙丝进行触觉、痛觉检查，检查时应避免溃疡或胼胝处，并于双足第一趾骨关节头进行VPT震动感觉阈值检查，同一部位只能重复检查2次，最后行四肢多普勒血流图检查，检查部位包括足背动脉、肱动脉、颈动脉等，计算公式，踝肱指数(ABI)=踝部血压/上臂血压，正常：ABI正常范围0.9～1.3;轻度血管病变：ABI≤0.71～0.90;中度血管病变：ABI≤0.41～0.70;重度血管病变：ABI≤0.40;ABI>1.31时，则提示血管显著钙化[3]。, http://www.100md.com(刘苑清 邓国宝 刘阳优)