特殊个体化护理对老年糖尿病人工全膝关节置换术患者的影响

Effect of special care on the effect of total knee arthroplasty and postoperative blood glucose in elderly diabetic patients

目的探讨特殊化护理对老年糖尿病人工全膝关节置换术(TKA)的影响。方法选取2016年6月—2018年6月江苏省连云港市第一人民医院收治的老年糖尿病TKA患者120例,按随机字母表法分为对照组及观察组,各60例。对照组给予常规护理干预,观察组在常规护理基础上给予特殊化护理干预,术后6个月,比较两组围术期血糖指标、护理质量、护理满意度、美国特种外科医院(HSS)、膝关节活动度(ROM)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及并发症的差异。结果两组护理干预前糖化血红蛋白(HbA1c)、餐后2 h血糖(2hPG)、空腹血糖(FPG)比较,差异均无统计学意义(P>0.05);护理干预后两组HbA1c、2 hPG、FPG均低于干预前,且观察组均低于对照组(P<0.05);术后6个月进行疗效评估,观察组护理质量、护理满意度、HSS评分及ROM评分均高于对照组(P<0.05);两组SAS、SDS评分均低于干预前,且观察组低于对照组(P<0.05);观察组并发症及TKA翻修术发生率均低于对照组(P<0.05)。结论特殊化护理干预对老年糖尿病TKA患者有明显影响,可促进疗效,改善血糖水平,并降低并发症发生率,提升护理质量。

Objective To explore the effect of special nursing on elderly patients with diabetic total knee replacement(TKA).Methods From June 2016 to June 2018,120 elderly patients with diabetic TKA admitted to the First People's Hospital of Lianyungang City,Jiangsu Province were selected.According to random alphabet method,the patients were divided into control group and observation group,60 cases in each group.The control group was given routine nursing intervention,and the observation group was given special nursing intervention based on routine nursing.Comparison of perioperative blood glucose indexes,nursing quality,nursing satisfaction,hospital for special surgery(HSS),knee of motion(ROM),and self-rating anxiety scale(SAS),self-rating depression scale(SDS)score and differences in complications.Results Comparison of glycosylated hemoglobin(HbA1c),blood glucose(2hPG)and fasting blood glucose(FPG)before nursing intervention between the two groups showed no statistically significant differences(P>0.05);HbA1c,2 hPG,and FPG were lower in the two groups after the nursing intervention than before the intervention,and the observation group were lower than those in the control group(P<0.05);efficacy evaluation was performed six months after operation,and the nursing quality,nursing satisfaction,HSS score,and ROM scores of the observation group were higher than those in the control group(P<0.05);SAS and SDS scores in both groups were lower than those before intervention,and those in the observation group were lower than the control group(P<0.05);the incidence of complications and TKA revision in the observation group was lower than that in the control group(P<0.05).Conclusion Special nursing intervention has obvious influence on elderly diabetic TKA patients,which can promote the curative effect,improve the blood sugar level,reduce the incidence of complications,and improve the quality of care.