社区2型糖尿病患者周围血管病变的现况调查与护理对策

The investigation of community type 2 diabetic patients with peripheral arterial disease and nursing countermeasures

目的 调查社区2型糖尿病患者周围血管病变的现况,分析影响因素并提出相应的护理对策.方法 对上海市某社区210例2型糖尿病患者采用超声多普勒血流探测仪测量踝肱指数（ABI）及动脉峰值血流速度,进行足部症状与体征评估以及糖化血红蛋白（HbAlc）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等相关实验室检查.结果 49例患者ABI＜0.9,该组足部皮肤颜色异常、水肿、足背动脉搏动异常、冷感所占比例大于ABI≥0.9组,而休息时疼痛、间歇性跛行等指标2组比较差异无统计学意义;Logistic逐步回归分析表明,增龄、LDL-C不达标是周围血管病变发生的危险因素,足背动脉峰值流速快是周围血管病变发生的保护因素.结论 应早期筛查周围血管病变,在治疗的基础上采取相应的护理对策,防止周围血管病变的进一步发展,达到有效预防糖尿病足的目的.

Objective To investigate the status of community type 2 diabetic patients with peripheral arterial disease,analyze the influencing factors and put forward nursing countermeasures.Methods 210 type 2 diabetic patients living in a community in Shanghai were enrolled in the investigation.ABI and arterial peak velocity were measured using Doppler blood flow detector,symptoms and signs of foot were assessed and related laboratory examinations,including HbA1c,HDL-C,LDL-C were tested.Results There were 49 cases of ABI 〈 0.9.The proportion of abnormal color of foot skin,edema,abnormal pulsation of dorsal artery of foot and sense of coldness in group of ABI 〈 0.9 were larger than group of ABI≥0.9.There was no statistical significance between the two groups in the pain at rest and intermittent claudication.Logistic stepwise regression analysis showed that age and LDL-C not up to the standard were risk factors of PAD and the peak of foot dorsal artery flow was a protective factor of PAD.Conclusions It＆#39;s important to early screen for PAD and to adopt corresponding nursing measures on the basis of treatment.We hope to further prevent the development of PAD and effectively prevent diabetic foot.