CAJ | 학술논문

目的：对糖尿病肾脏疾病( DKD)住院患者初次诊断时的临床情况进行分析,为临床治疗护理提供参考。方法收集2003年1月至2008年12月在我院首次诊断为DKD的1242例住院患者的临床资料,并追踪随访,分析相关指标。结果对初诊时为Mogensen Ⅲ、Ⅳ和Ⅴ期的病例进行单因素方差分析发现,糖尿病病程、血红蛋白、白蛋白、肌酐、空腹血糖、餐后血糖、糖化血红蛋白值、平均动脉压、收缩压、舒张压等指标的差异有统计学意义( P<0．05)；且血糖值随着分期增加而降低,Ⅲ、Ⅳ期患者血糖控制较差；Ⅴ期患者血压控制最差。护理上应结合患者各期的病情特点,对血压、血糖、饮食及药物治疗进行有效管理和调整,以延缓病情进展,提高生活质量,改善预后。结论早期诊断并结合不同分期患者的临床特点,做好各期DKD患者的护理,提高患者的疾病自我管理能力,可改善患者预后。
목적：대당뇨병신장질병( DKD)주원환자초차진단시적림상정황진행분석,위림상치료호리제공삼고。방법수집2003년1월지2008년12월재아원수차진단위DKD적1242례주원환자적림상자료,병추종수방,분석상관지표。결과대초진시위Mogensen Ⅲ、Ⅳ화Ⅴ기적병례진행단인소방차분석발현,당뇨병병정、혈홍단백、백단백、기항、공복혈당、찬후혈당、당화혈홍단백치、평균동맥압、수축압、서장압등지표적차이유통계학의의( P<0．05)；차혈당치수착분기증가이강저,Ⅲ、Ⅳ기환자혈당공제교차；Ⅴ기환자혈압공제최차。호리상응결합환자각기적병정특점,대혈압、혈당、음식급약물치료진행유효관리화조정,이연완병정진전,제고생활질량,개선예후。결론조기진단병결합불동분기환자적림상특점,주호각기DKD환자적호리,제고환자적질병자아관리능력,가개선환자예후。
Objective To investigated the clinical status of patients with diabetic kidney disease ( DKD) at first hospitali-zation, so as to provide reference for clinical nursing practice. Methods Clinical data of 1242 patients with DKD admitted to our hospital from January 2003 through December 2008 were collected, these patients were followed up. The clinical characteristics of these patients were summarized and the relevant indicators were analyzed. Results ANOVA analysis indicated that there was sig-nificant difference in diabetic course, levels of hemoglobin, serum albumin, creatine,fasting blood glucose, postprandial hypergly-cemia, glycosylated hemoglobin, mean arterial pressure, systolic pressure and diastolic pressure compared among patients in three Mogensen stages(P<0. 05). And blood glucose level reduced as the Mogensen stage progressed. Poor glycemic control was obvi-ous in patients in Ⅲ and Ⅳ stages, and hypoglycemia happened more frequently in the Ⅴstage patients. Moreover, poor blood pressure control was also seen in patients at Ⅴstage. Careful nursing should consider the clinical features of patients in different stages and the effective management of blood pressure、blood glucose should be carried out so as to decelerate the procession and improve the quality of life. Conclusions Early diagnosis and treatment with respective strategies according to the different clinical characteristics ofthe patients in different stages may improve the self-management and the outcome of DKD patients.