脊柱结核合并糖尿病患者围手术期应用胰岛素泵治疗的疗效观察与护理

Nursing and observation on spinal tuberculosis patients complicated with diabetics treated with insulin pump during perioperative period

目的 比较脊柱结核合并2型糖尿病患者在围手术期不同胰岛素给药方法的疗效并总结护理体会.方法 对60例脊柱结核合并糖尿病拟行手术治疗的患者分为胰岛素泵治疗组（实验组）和每日多次皮下胰岛素注射组（对照组）,比较两组间血糖控制及其时间、胰岛素用量、低血糖发生率、切口愈合等方面的差异,回顾总结护理措施.结果 两组均能获得良好的血糖控制,实验组血糖控制优于对照组（P＜0.01）,术前血糖控制时间、住院总天数及低血糖发生率均低于对照组（P＜0.01）,两组切口感染率无明显差异;无一例发生术后并发症,均康复出院.结论 胰岛素泵用于脊柱结核患者围手术期血糖控制比常规多次皮下注射系统疗效更为优越;做好术前心理护理、埋置胰岛素泵部位的皮肤护理、健康教育和术后血糖的监测、并发症的预防是保证疗效的护理关键.

Objective To compare the curative effect of the insulin with different routes of administration in spinal tuberculosis patients complicated with diabetics during perioperative period and to summarize nursing experience. Methods A total of 60 cases of spinal tuberculosis complicated with diabetics before surgical treatment were divided into two groups：experimental group treated with insulin pump and control group treated with insulin subcutaneous injection. The conditions of blood glucose, insulin dosage, incidence of hypoglycemia, wound healing were compared between two groups. Results Blood glucose in two groups were controlled well but experimental group was superior to control group. experimental group had lower incidence of hypoglycemia,fewer hospital stay than control group. Wound infection in two groups was similar and no one appeared complications. Conclusions In controlling blood glucose, the insulin pump is superior to insulin subcutaneous injection.Enhancing psychology nursing, skin nursing, health education, blood glucose monitoring and complication prevention can ensure therapeutic effectiveness.