糖尿病腹膜透析病人足部评估及护理现状调查

Investigate of foot conditions and foot care status of peritoneal dialysis patients with diabetic nephropathy

目的了解糖尿病肾病行腹膜透析病人足部病变的状况,所接受到的足部护理教育和指导,以及足部自我护理的情况。方法采用英国足部筛查实验对46例糖尿病肾病腹透病人的足部神经病变进行症状和体检评分;应用触摸动脉搏动和测量踝-臂指数(ABI)来判断病人的足部血管病变状况;同时应用问卷调查病人的足部护理行为能力和曾接受过的足部护理教育和指导。结果73.9%的病人存在足部周围神经病变,41.3%的病人动脉搏动异常,同时存在以上两种情况的病人占37%;ABI的测定表明,54.3%的病人存在不同程度的血管病变。76.1%的病人在过去1年中未接受过糖尿病教育,91.3%的病人从未接受过糖尿病足的评估,84.8%的病人从未接受过足部护理指导。他们的足部自我护理行为,尤其是每日足部检查和鞋子检查的得分较低。结论糖尿病肾病行腹透的病人足部病变状况比较严重,但足部自我护理行为较差,所接受的教育和指导不够,需要引起医护人员的重视。

Objective To investigate the foot condition, self care activities and acquired education on foot care of peritoneal dialysis patients with diabetic nephropathy. Methods Forty-six diabetic patients undergoing peritoneal dialysis were enrolled in this study. The United Kingdom foot screening test, palpation of pulse on lower limbs arteries, and ankle-brachial index（ABI）were used to evaluate the neuropathy and vasculopathy condition of patients＇ feet. The self care activities and acquired education on foot care were evaluated by an self reported questionnaire. Results 73.9% patients had neuropathy, 41.3% patients had arterial pulse abnormality, meanwhile 37% of them had both. 76.1% patients had never accepted diabetic education program,91.3% and 84.8% of them had never accepted foot condition evaluation or direction by medical staff. Their self care activities, especially daily inspection on foot and shoes were under optimized. Conclusion The foot problems were severe in diabetic patients＇ undergoing peritoneal dialysis. The self care activity of foot care was poor, and they need more instructions.