肝部分切除术后血糖应激性升高对患者血小板计数及血液状态的影响及护理干预

Effect of Stress Blood Glucose Elevating After Partial Hepatectomy on Patients' Platelet Count and Blood Status and Nursing Intervention

目的分析肝部分切除术后血糖应激性升高的护理干预方案对患者血小板计数及血液状态的影响。方法选取自2012年2月~2015年2月于我院接受肝部分切除术后血糖应激性升高的80例患者作为研究对象,按入院顺序随机分为对照组与观察组2组,每组40例。2组均给予免疫抑制剂处理。对照组则仅给予皮下注射胰岛素干预,观察组则采用微泵静注胰岛素干预,同时作强化护理,比较2组血小板计数及血液状态的变化情况。结果术后3 d餐前、餐后2 h、睡前观察组血糖水平分别为（5.3±1.6）mmol/L、（6.7±1.3）mmol/L、（5.4±2.2）mmol/L,与对照组相比差异有统计学意义（P0.05）。结论在肝部分切除术后血糖应激性上升患者的护理干预中,采用微量胰岛素泵注联合强化护理方案,可缩短患者血糖达标时间,改善其血液指标。

Objective To analyze the nursing intervention sheme for stress blood glucose elevating after partial hepatectomy on platelet count and blood status in patients. Methods 80 patients with stress blood glucose elevating who received partial hepatectomy in the hospital during February 2012 to February 2015 were selected as the research objects. According to the order of admission,the objects were randomly divided into the control group and the observation group of 2 groups with 40 cases in each group. The 2 groups were treated with immunosuppressive agents. The control group was inly given subcutaneous injection of insulin,while the observation group was treated with intravenous infusion of insulin and intensive nursing. The changes of platelet count and blood status were compared between the 2 groups. Results The blood glucose levels in postoperative 3 d before the meal,postprandial 2 h and before sleep in the observation group were（ 5. 3 ± 1. 6）mmol / L,（ 6. 7 ± 1. 3） mmol / L and（ 5. 4 ± 2. 2） mmol / L,respectively. Compared with the control group,the differences were statistically significant（ P〈0. 05）. Intraoperative,at the end of operation and postoperative 24 h Hb and Hct were higher than those in the control group（ P〈0. 05）. At the end of operation,the platelet count level in the observation group was significantly higher than that in the control group（ P〈0. 05）. The time for blood glucose reaching the standard in the observation group was（ 4. 8 ± 0. 7） d while in the control group was（ 8. 7 ± 2. 4） d and the difference was statistically significant（ P〈0. 05）,but there was no significant difference in the incidence rate of complications between the 2 groups（ P〉0. 05）. Conclusion In the nursing intervention of patients with stress blood glucose elevating after partial hepatectomy,to adopt trace amount of insulin infusion combined with intensive nursing can shorten the time for blood glucose reaching the standard and improve the blood indexe.