远程网络护理干预对使用胰岛素笔糖尿病患者的影响

Effect of long-distance network nursing intervention on diabetic patients with using insulin pen

目的探讨远程网络护理干预在使用胰岛素笔的糖尿病患者中应用的临床效果。方法对240例需要注射胰岛素的2型糖尿病出院患者随机分为两组，干预组（n=120）进行远程网络护理干预模式进行个体化健康教育，对照组（n=120）采用常规方法进行健康教育。观察3个月后比较两组患者胰岛素笔使用的掌握程度、胰岛素治疗依从陛、血糖控制情况。结果干预组患者了解注射时检查笔芯中药液的性状、查药物的有效期、待酒精干后再注射、根据皮下脂肪的厚度进行正确的注射、拔针后不需用干棉签按压注射部位、更换注射部位、正确保存胰岛素笔、低血糖发生率和血糖控制等方面均优于对照组，差异具有统计学意义（p〈0.05）；两组患者出院时对胰岛素治疗依从l生、空腹血糖、餐后2h血糖差异均无统计学意义（P〉0．05）；出院后3个月干预组完全依从率为91．7％，餐后2h血糖（7．6±1．1）mmol／L，糖化血红蛋白（6．4±0．9）mmol／L，与对照组比较[75．0％，（9．8±2，2），（7．5±1．2）mmol／L]，差异均有统计学意义（x2=12．00，t分别为12．06，6．85；P〈0．01）。结论远程网络护理干预是一种简便、直观而准确的教育模式，患者胰岛素笔使用情况较好，提高患者对胰岛素笔的正确使用率和胰岛素治疗的依从性，从而有效控制血糖。

Objective To study the effect of long-distance network nursing intervention （LDNNI） on diabetic patients with using insulin pen （Novopen）. Methods Totals of 240 patients with type 2 diabetes mellitus that received insulin therapy were randomly divided into intervention group and control group,with 120 cases for cache group. Intervention group received the individuation health education by LDNNI and control group received traditional health education. The correct rate of using insulin pen, the compliance of insulin treatment, and the blood glucose control situation were analyzed in two groups. Results After intervention, the correct rate of using insulin pen such as examining the property and time before injection, injecting after alcohol desiccation and its depth based on the fatty thickness, alternating sites of injection, no depression after injection and correcte storage of the pen in intervention group were better than that of control group（P 〈 0. 05 ）. There was no significant difference on the compliance of insulin treatment, fasting glucose and blood glucose level after meal two hours in two groups when they discharge（P 〉0. 05）. The compliance rate of insulin treatment （91.7%） ,glucose after meal two hours[ （7.6±1.1 ） mmol/L] and glycated hemoglob[ （6.4±0.9） mmol/L] in intervention group were higher than that of control group with 75.0%, （9.8 ±2.2） mmol/L, （7.5±＋ 1.2） mmol/L respectively,and difference was statistically significant（X2=1 200, t = 1206,6. 85, respeitiudy;P 〈 0. 01 ）. Conclusions The application of long- distance network nursing intervention in health education for type 2 diabetic patients is scientific and helpful with simple, direct-viewing, and accurate. It can improve their awareness of health knowledge, increase the correction rate of using Novopen, enhance the patients＇ complicance of insulin treatment, and control their blood glucose better.