血糖漂移度对慢性乙型肝炎患者病情进展的影响及护理

Influences of blood glucose excursion on the progression of chronic hepatitis B patients and nursing intervention

目的分析血糖漂移度对慢性乙型肝炎患者病睛进展的影响，并探讨护理干预方法。方法选取无锡市第五人民医院2012年7月-2014年12月收治的40例慢性乙型肝炎患者为研究对象，采用实时动态血糖监测仪TA—DRb监测患者的血糖，3d后根据血糖监测值的不同将该组患者分为血糖高漂移组24例（A组）、血糖无漂移组4例（B组）、血糖低漂移组12例（C组），测定患者的血清总胆红素（TBiL）、凝血酶原时间（PT）、人血白蛋白（ALB）、胆碱酯酶（CHE）、胰岛素的水平。结果A、C两组患者的胛长于B组，TBiL、胰岛素水平高于B组，CHE、ALB低于B组，差异有统计学意义（P〈0．05）；经相应的治疗和护理后，A、C两组的盯缩短，TBiL、胰岛素降低，CHE、ALB升高，差异有统计学意义（P〈0．05）。结论血糖异常影响慢性乙型肝炎患者的预后，根据血糖漂移度对患者进行相应的治疗和护理，可有效控制患者的病情。

Objective To investigate the influences of blood glucose excursion on the progression of chronic hepatitis B patient, and to explore the nursing intervention methods. Methods The study investigated 40 cases of chronic hepatitis B patients who admitted to the Fifth People＇ s Hospital of Wuxi from July 2012 to December 2014. After three days, with the help of the real-time continuous glucose monitor TA-DRb, the patients were divided into three groups including： high blood glucose excursion group （group A, n = 24） ; none blood glucose excursion group （ group B, n =4） ; and low blood glucose excursion group （ group C, n = 12）. The testing items included serum total bilirubin （TBiL）, prothrombin time （PT）, serum albumin （ALB）, choline esterase （CHE） and the level of insulin. Results In group A and C, TBiL and the level of insulin were higher; PT was longer; ALB and CHE were lower, compared with group B （P 〈 0.05）. After the nursing intervention, TBiL, PT and the level of insulin reduced; ALB and CHE increased （P 〈 0.05 ）. Conclusions The prognosis of patients with chronic hepatitis B is affected by abnormal blood glucose, and the corresponding treatment and nursing care according to blood glucose excursion can effectively control the progression of the illness.