脑卒中并低血糖症36例临床护理研究

Research on nursing care in the treatment of 36 patients with stroke associated with hypoglycemia

目的:探讨脑卒中住院后低血糖症的临床特点及护理措施。方法:对我院收治的脑卒中并低血糖症36例(观察组)的临床表现特点、护理措施进行回顾性分析,随机抽取无脑卒中患者(对照组)住院后发生低血糖者36例作对照分析。结果:观察组低血糖发生率为0.89%(36/4045),对照组发生率为0.78%(36/4638),P>0.05;观察组与对照组相关指标比较:存在不同程度吞咽困难分别为12例、1例;发生低血糖前意识障碍分别为12例、2例;发生低血糖后,伴不同程度意识改变分别为30例、12例;出现明显的低血糖交感神经兴奋表现分别为10例、25例。两组比较差异有统计学意义(P<0.01)。存在抑郁表现影响进食者分别为14例、5例;无任何警示症状,仅在常规的血糖监测发现脑卒中低血糖分别为11例、3例(无症状);伴血钾紊乱分别为13例、5例;最终死亡分别为13例、5例。两组比较差异有统计学意义(P<0.05)。针对观察组的临床特点提出了相应的护理对策。结论:脑卒中患者合并低血糖症临床表现多不典型,预后相对较差,加强护理及时发现并纠正低血糖是重要措施。

Objective：To study the clinical features of hypoglycemia of patients with stroke after admission and nursing measures. Methods：Clinical features of 36 stroke patients （taken as observation group） associated with hypoglycemia and nursing measures were retrospectively analyzed,another randomly selected 36 patients who suffered from hypoglycemia after admission but had no stroke were taken as control group and their clinical features were comparatively analyzed. Results：The incidence of hypoglycemia was 0.89% （ 36/4045） in observation group and 0. 78% （36/4638） in control group （ P 〉 0. 05 ）. The comparison of related indicators was made between observation group and control group as follows ： dysphagia were respectively 12 cases and 1 case; disturbance of consciousness before occurrence of hypoglycemia occurred in 12 cases and 2 cases; different change of consciousness after occurrence of hypoglycemia appeared in 30 cases and 12 cases; sympathetic nervous excitement due to hypoglycemia happened to 10 cases and 25 cases. The comparison was significant different between the two groups （ P 〈 0.01）. Poor appetite due to depression occurred in 14 cases and 5 cases respectively; hypoglycemia was detected only by blood glucose monitoring but without any warning sign in 11 cases and 3 cases （asymptomatic） ; potassium disorder occurred in 13 cases and 5 cases and dead cases were respectively 13 cases and 5 cases （P 〈 0.05）. The corresponding nursing measures were put forward according to clinical features of the patients in observation group. Conclusion ： The clinical manifestations in patients with stroke associated with hypoglycemia are not typical and the prognosis is relatively poor. To enhance nursing care and timely correct hypoglycemia are very important.