CAJ | 학술논문

目的探讨改良护理干预对危重患者实施强化胰岛素治疗方案的效果.方法采用历史对照法将258例实施强化胰岛素治疗的危重患者分为对照组126例和观察组132例.对照组实施常规强化胰岛素治疗,护士根据医嘱及个人经验调节胰岛素用量及血糖监测频率;观察组采用"改良胰岛素使用指引"及相应护理干预进行强化胰岛素治疗.对比两组患者首次达到目标血糖范围所需要的时间,4 d内平均测血糖的次数,每天血糖的波动幅度,治疗期间低血糖发生频率,低血糖患者例数等指标.结果观察组使用"改良胰岛素使用指引"及相应护理干预后患者首次达到目标血糖范围所需要的时间更早,血糖首次达到目标范围的时间为(11.95±1.97)h,而对照组为(18.85±3.59)h,差异有统计学意义(t=19.237 3,P＜0.01);观察组测血糖次数明显减少,血糖波动幅度减小,低血糖发生率及患者例数均明显少于对照组(P＜0.01).结论采用"改良胰岛素使用指引"及相应护理干预在危重患者实施强化胰岛素治疗方案中能较好地控制血糖,明显减少低血糖次数,改善预后.
목적 탐토개량호리간예대위중환자실시강화이도소치료방안적효과.방법 채용역사대조법장258례실시강화이도소치료적위중환자분위대조조126례화관찰조132례.대조조실시상규강화이도소치료,호사근거의촉급개인경험조절이도소용량급혈당감측빈솔;관찰조채용"개량이도소사용지인"급상응호리간예진행강화이도소치료.대비량조환자수차체도목표혈당범위소수요적시간,4 d내평균측혈당적차수,매천혈당적파동폭도,치료기간저혈당발생빈솔,저혈당환자례수등지표.결과 관찰조사용"개량이도소사용지인"급상응호리간예후환자수차체도목표혈당범위소수요적시간경조,혈당수차체도목표범위적시간위(11.95±1.97)h,이대조조위(18.85±3.59)h,차이유통계학의의(t=19.237 3,P＜0.01);관찰조측혈당차수명현감소,혈당파동폭도감소,저혈당발생솔급환자례수균명현소우대조조(P＜0.01).결론 채용"개량이도소사용지인"급상응호리간예재위중환자실시강화이도소치료방안중능교호지공제혈당,명현감소저혈당차수,개선예후.
Objective To investigate the clinical effect of improved nursing intervention in blood glucose control of critical patients. Methods By means of historical control, 258 critical patients undergone intense insulin therapy were divided into the control group (n = 126) and the test group (n = 132). The control group was given conventional intensive insulin therapy. The test group was given improved guidelines on the use of insulin and improved nursing intervention. The following indexes of the two groups were documented and compared: the time required to achieve target blood glucose level [(11.95 ± 1.97) h vs (18.85 ± 3.59) h, t =19. 237 3 ,P ＜0. 01]; frequency of blood glucose measuring in four days, the range of everyday blood glucose and the occurrence of hypoglycemia during therapy. Results The test group had shorter time required to achieve target blood glucose level, lower frequency of blood glucose measuring, less fluctuation range of blood glucose and reduced occurrence of hypoglycemia during therapy than the control group (P ＜ 0. 01). Conclusions The use of improved guidelines on the use of insulin and improved nursing intervention in intensive insulin therapy of critical patients can effectively control blood glucose, reduce frequency of hypoglycemia and improve prognosis.