研究综合护理方案对小儿糖尿病酮症酸中毒的护理效果

Study on the Nursing Effect of Comprehensive Nursing Program on Children with Diabetic Ketoacidosis

目的探索用于小儿糖尿病酮症酸中毒(diabetes mellitus ketoacidosis,DMKA)综合护理方案的应用效果。方法随机选择2020年6月—2021年9月在该院接受DMKA治疗的患儿96例,入院时通过随机原则分为参照组、研究组,每组48例,参照组采用常规护理措施,研究组在此基础上实施综合护理方案。对比两组患儿的并发症发生率、患儿家属护理满意度调查、临床症状改善时间、血糖控制情况。结果研究组患儿家属的护理满意度显著高于参照组,差异有统计学意义(χ^(2)=5.031,P=0.025)。研究组患儿每日胰岛素用药剂量、血糖下降速度以及低血糖发生率显著低于参照组,差异有统计学意义(t=5.429、8.299,χ^(2)=4.909,P<0.05)。两组患儿的尿酮体转阴时间、DMKA纠正时间以及总住院时间3个指标,差异无统计学意义(t=0.539、0.499、0.306,P=0.591、0.618、0.761)。两组患儿餐后2 h血糖、空腹血糖、血钾、血钠浓度改善等相关指标,差异无统计学意义(t=0.219、0.154、1.199、0.647,P=0.826、0.878、0.233、0.519)。结论对DMKA小儿在护理时基于常规护理措施实施综合护理方案,从病情观测、心理护理、饮食护理、胰岛素用药指导等方面进行护理,能够保障患儿血糖水平改善速率更加稳定,有效降低患儿并发症发生率,提高患儿家属护理满意度,充分体现出了综合护理方案在促进DMKA患儿健康方面的意义。

Objective To explore the application effect of comprehensive nursing program for children with diabetic ketoacidosis(diabetes mellitus ketoacidosis,DMKA).Methods A total of 96 children who received DMKA treatment in the hospital from June 2020 to September 2021 were randomly selected and randomly divided into a reference group and a study group,with 48 cases in each group.The reference group received routine nursing care.On this basis,the study group implemented a comprehensive nursing program.The incidence of complications,the nursing satisfaction survey of children's family members,the improvement time of clinical symptoms,and blood glucose control were compared between the two groups.Results The nursing satisfaction of family members of the study group was significantly higher than that of the reference group,and the difference was statistically significant(χ^(2)=5.031,P=0.025).The daily insulin dose,blood glucose drop rate and incidence of hypoglycemia in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=5.429,8.299,χ^(2)=4.909,P<0.05).There were no statistically significant differences in urine ketone body tum overcast time,DMKA correction time and total length of hospital stay between the two groups(t=0.539,0.499,0.306,P=0.591,0.618,0.761).There were no statistically significant differences in 2 h postprandial blood glucose,fasting blood glucose,blood potassium and sodium concentration between the two groups(t=0.219,0.154,1.199,0.647,P=0.826,0.878,0.233,0.519).Conclusion Implementing a comprehensive nursing plan based on routine nursing measures for children with DMKA during nursing,nursing from the aspects of disease observation,psychological nursing,dietary nursing,insulin medication guidance,etc.,can ensure a more stable improvement rate of blood glucose levels in children,and effectively reduce the incidence of complications in children.The incidence of DMKA and the nursing satisfaction of family members of children are improved,which fully reflects the significance of comprehensive nursing program in promoting the health of children with DMKA.