艾塞那肽靶点治疗2型糖尿病患者的护理干预

Nursing of patients with type 2 diabetes mellitus using exenatide targets site treatment

目的探讨艾塞那肽在单用二甲双胍（MET）、磺酰脲类（su）或MET＋SU联合治疗血糖控制欠佳的2型糖尿病患者中的疗效，寻找有效的护理对策。方法将24例患者随机分为对照组与艾塞那肽组各12例；艾塞那肽5gg2次／d先治疗4周，然后lOgg2次，d治疗12周。观察2组从基线到终点的糖化血红蛋白（HbAlc）、BMI、空腹血糖（FBG）、餐后2h血糖（P2hBG）指标的变化，及在护理干预前后2组的不良反应率。结果对照组患者HbAlc、BMI、FBG、P2hBG水平与治疗前无明显差异；艾塞那肽组治疗后与治疗前及治疗后的对照组相比上述指标的水平均显著下降，护理干预对应用艾塞那肽产生恶心、呕吐、腹泻、低血糖、头痛的不良反应均有显著效果。结论单用MET、SU或用MET＋SU联合治疗控制效果欠佳的2型糖尿病患者，加用艾塞那肽靶点治疗可长期有效控制血糖，疗效卓越；通过护理干预可明显缓解不良反应对患者的影响。

Objective To explore exenatide in the treatment of mefformin（MET）alone, sulfonylurea （SU）alone or MET ＋ SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures. Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group. In the exenatide group, exenatide 5μg twice a day for 4 weeks, then 10/.tg twice a day for 12 weeks. Changes of HbAle, body weight, BMI, FBG, P2hBG, and rate of adverse reaction were compared between two groups. Results Glycosylated hemoglobin （HbAlc）, body weight, BMI, FBG, P＇2hBG in the control group before and after treatment showed no significant difference, while the exenatide group showed better results compared with those before treatment and the control group. Nursing intervention played evident effect on reducing adverse effect such as nausea, vomiting, diarrhea, low blood sugar, headache. Conclusions For patients with type 2 diabetes, using MET, SU alone or MET ＋ SU combination therapy showed poor results of blood sugar control, addition of exenatide therapy can effectively control blood sugar, nursing intervention can significantly alleviate the adverse effects of patients.