CAJ | 학술논문

[目的]探讨延续护理在糖尿病无症状下肢动脉粥样硬化性病变(LEAD )病人护理中的应用效果。[方法]选择2014年3月—2014年9月93例多普勒超声血流仪测量踝肱动脉指数(ABI)≤0.9的无症状 LEAD 糖尿病病人，采用延续护理方法，以评估问题、实施计划、及时评价3个步骤进行干预，对病人出院3个月、6个月后的血糖、血脂、血压、足部外观状况、下肢血管病变及周围神经病变进行监测，观察不同时期自我护理能力的差异。[结果]出院后6个月，病人空腹血糖(FPG)、餐后2 h 血糖(2 hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TG)、高密度脂蛋白胆固醇(HDL C)、低密度脂蛋白胆固醇(LDL C)、血压、体重指数(BMI)等明显改善(P <0.01)；自我护理能力得分明显提高(P <0.01)；足部颜色、感染、足背动脉、肢体麻木、踝反射、振动觉、压力觉、针刺觉及温度觉的异常等均有改善(P <0.05)。[结论]延续护理干预能提高无症状 LEAD 糖尿病病人的自我护理能力，改善病人血糖、血脂、血压等指标，降低足溃疡和截肢的危险。
[목적]탐토연속호리재당뇨병무증상하지동맥죽양경화성병변(LEAD )병인호리중적응용효과。[방법]선택2014년3월—2014년9월93례다보륵초성혈류의측량과굉동맥지수(ABI)≤0.9적무증상 LEAD 당뇨병병인，채용연속호리방법，이평고문제、실시계화、급시평개3개보취진행간예，대병인출원3개월、6개월후적혈당、혈지、혈압、족부외관상황、하지혈관병변급주위신경병변진행감측，관찰불동시기자아호리능력적차이。[결과]출원후6개월，병인공복혈당(FPG)、찬후2 h 혈당(2 hPG)、당화혈홍단백(HbA1c)、총담고순(TG)、고밀도지단백담고순(HDL C)、저밀도지단백담고순(LDL C)、혈압、체중지수(BMI)등명현개선(P <0.01)；자아호리능력득분명현제고(P <0.01)；족부안색、감염、족배동맥、지체마목、과반사、진동각、압력각、침자각급온도각적이상등균유개선(P <0.05)。[결론]연속호리간예능제고무증상 LEAD 당뇨병병인적자아호리능력，개선병인혈당、혈지、혈압등지표，강저족궤양화절지적위험。
Objective:To probe into the application effect of continuity of care in nursing care of diabetes mellitus patients complicated with asymptomatic lower extremity atherosclerotic disease (LEAD).Methods:A total of 93 cases of diabetes mellitus patients with were asymptomatic LEAD selected who received Doppler ultrasonic flowmeter measurement of ankle brachial index (ABI)≤0.9 from March in 2014 to September in 2014.The continuity of care was used,through the three steps including problem assessment,plan implementation and timely evaluation to intervene and monitor the blood glucose,blood lipids,blood pressure,foot appearance,lower extremity vascular lesion and peripheral nerve lesion at 3 months and 6 months after discharge.The difference of self nursing ability was observed in different periods.Results:At 6 months after discharge,the patients’many indexes were improved including fasting postprandial blood glucose(FPG),2 h postprandial blood glucose (2 hPG),gly-cosylated hemoglobin(HbA1 C ),total cholesterol(TG),high density lipoprotein cholesterol(HDL C),low density lipoprotein cholesterol(LDL C),blood pressure and body mass index(BMI)(all P <0.01 ).The score of self care ability increased significantly(P <0.01).The abnormal of foot color,infection,foot back artery,limb numb-ness,ankle reflex,vibration feeling,pressure feeling,acupuncture feeling and temperature feel were significantly improved(P <0.05).Conclusion:Continuity of care can improve the self care ability of diabetes patients with a-symptomatic LEAD.It can improve the patients’blood glucose,blood lipids,blood pressure and other indica-tors,and reduce the risk of foot ulcers and amputation.