个体跟进式护理方案在糖尿病合并脑梗死患者中的应用及预后影响

Application of individual follow-up nursing scheme in the patients with diabetes mellitus complicated with cerebral infarction and its prognostic effect

目的探讨和研究个体跟进式宣教护理方案应用于糖尿病合并脑梗死患者治疗中的效果及预后的相关性。方法选取我院神经内科2015年1~9月收治的100例糖尿病合并脑梗死患者,采用随机数字表法将其分为对照组50例和观察组50例。对照组实施神经内科常规护理及治疗,观察组患者在对照组的基础上实施个体跟进式宣教护理方案。干预前后采用日常生活能力评定量表(ADL)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、积极度量表(PAM)、空腹血糖(FBG)及餐后2 h血糖(PBG2h)对两组患者的日常生活能力、心理状况、积极度、空腹血糖及餐后2 h血糖控制情况进行评价。出院后随访2年。结果干预后,观察组患者ADL评分高于对照组(P<0.05);观察组患者HAMA、HAMD评分低于对照组(P<0.05);观察组患者PAM评分高于对照组(P<0.05);观察组患者FBG及PBG2h值低于对照组(P<0.05)。随访2年,观察组<2年脑梗死总复发率12.24%,对照组28.57%。根据Kaplan-Meier生存曲线,两组比较差异有统计学意义(P<0.05)。结论个体跟进式宣教护理方案能有效提高糖尿病合并脑梗死患者的治疗效果及血糖控制能力,减少患者<2年脑梗死复发的风险。

Objective To investigate and study the correlation between the effect of individual follow-up education nursing scheme in the treatment of patients with diabetes mellitus complicated with cerebral infarction and its prognosis. Methods A total of 100 patients with diabetes mellitus complicated with cerebral infarction who were admitted to the Department of Neurology in our hospital from January 2015 to September 2015 were selected. The random number table method was used to divide the patients into control group （n=50） and observation group （n=50）. The control group was given routine nursing and treatment of neurology, and the observation group was given individual follow-up educa- tion nursing scheme on the basis of the control group. The ADL, HAMA, HAMD, PAM, FBG, and postprandial 2-hour blood glucose （PBG2h） were used before and after intervention to evaluate the daily living ability, psychological status, motivation, fasting blood glucose and 2-hour postprandial glycemic control in both groups. The patients were followed up for 2 years after discharge. Results After intervention, the ADL score in the observation group was higher than that in the control group （P〈0.05）; HAMA and HAMD scores in the observation group were lower than those in the control group（P〈0.05）; PAM score in the observation group was higher than that in the control group（P〈O.05）; the FBG and PBG2h values in the observation group were lower than those in the control group（P〈O.05）. After the follow-up for 2 years, the total recurrence rate of cerebral infarction 〈2 years was 12.24% in the observation group, and was 28.57% in the con- trol group. According to Kaplan-Meier survival curve, the difference between the two groups was statistically significant （P〈0.05）. Conclusion Individual follow-up education nursing program can effectively improve the therapeutic effect and blood glucose control ability of patients with diabetes complicated with cerebral infarction, and reduce the risk of re- current cerebral infarction 〈2 years.