延續性護理在尿路造口合并糖尿病患者中的應用

嚴曉莉　林寧　江平　吳玉蓮　陳淑珠　林崢　林小丹

【摘要】 目的：探討尿路造口合并糖尿病患者圍手術期實施延續性護理干預的應用效果。方法：選取2012年8月-2016年8月本院收治的60例尿路造口合并糖尿病患者，采用隨機數字表法將患者分為對照組和觀察組，每組30例。對照組采用傳統護理方式做好心理護理、血糖控制與監測、飲食管理，提供合理的營養支持，試驗組在對照組基礎上采取延續性護理干預。觀察兩組相關并發癥的發生情況，并采用自我護理能力實施量表進行問卷調查。結果：試驗組造口周圍皮膚炎及尿路感染情況均優于對照組，差異均有統計學意義（P<0.05）；試驗組造口自我管理能力在出院時效果優于對照組，差異有統計學意義（P<0.05）。結論：延續性護理方式可以提高尿路造口合并糖尿病患者造口自我管理能力，減少相關并發癥，效果顯著，值得推廣。

【關鍵詞】 延續性護理； 尿路造口； 糖尿病； 自我管理能力

Application of Continuing Care in Urostomy Patients Combined with Diabetes/YAN Xiao-li，LIN Ning，JIANG Ping，et al.//Medical Innovation of China，2017，14（22）：105-108

【Abstract】 Objective：To explore the effet of perioperative continuity nursing intervention in diabetes patients combined with urostomy.Method：From August 2012 to August 2016，60 urostomy patients combined with diabetes were selected，and divided into control group and experimental group according to the random number table method，30 cases in each group.Control group was adopted the traditional nursing method，completed the psychological nursing，blood sugar control and monitoring，diet management，to provide reasonable nutrition support，experimental group was given the continuity nursing intervention on the basis of control group.Observed the related complications of two groups，and implemented survey by self-care ability questionnaire.Result：The skin inflammation around the urostomy and urinary tract infections of experimental group were better than those of control group， the differences were statistic significant（P<0.05）；the self-management ability of experimental group was better than that of control group when discharge，the difference was statistic significant（P<0.05）.Conclusion：Continuity care intervention can obviously increase self-management ability of urostomy patients who combined with diabetes，reduce the related complications，which has remarkable effect and is worthy to be popularized.

【Key words】 Continuing care； Uurostomy； Diabetes； Self management ability

First-authors address：The First Affiliated Hospital of Fujian Medical University，Fuzhou 350000，China

doi：10.3969/j.issn.1674-4985.2017.22.031

糖尿病患者由于存在以高血糖為主的代謝紊亂，手術中發生危險及術后傷口不愈合、感染等發生率都大大高于正常人[1]。這些患者在手術創傷時，機體處于應激狀態，體內促分解代謝激素，如兒茶酚胺、糖皮質激素、胰高血糖素等分泌增多，使糖原分解和異生均增加，血糖升高，這將使得機體胰島素分泌障礙更為嚴重、對外源性胰島素的敏感性進一步降低，加劇機體的高糖血癥、營養不良及代謝紊亂，導致免疫力下降，影響傷口深層愈合，還容易導致感染及皮膚切口的愈合不良等[2]。糖尿病的發病率近年來在我國迅速增長，防治任重道遠[3]。

我國膀胱癌發病率為7.49/10萬，占中國惡性腫瘤發病構成的2.5%，居中國泌尿系惡性腫瘤發病第1位，并呈現逐年增長趨勢[4]。……