脊柱骨折合并糖尿病患者进行基于循证理念的预警性护理对其术后生活质量的影响

Effect of Early Warning Nursing Based on Evidence-based Concept on Postoperative Quality of Life in Patients with Spinal Fractures Complicated with Diabetes Mellitus

目的 探讨脊柱骨折合并糖尿病患者进行基于循证理念的预警性护理对其术后生活质量的影响。方法 选择2019年5月—2020年3月在厦门大学附属第一医院接受诊治的脊柱骨折术后糖尿病患者90例,根据随机对照法分为常规护理组(n=45)、循证预警护理组(n=45),常规护理组采用常规护理方式,循证预警护理组采用基于循证理念的预警性护理,两组均护理2周,比较两组护理后每周排便次数、视觉模拟评分评估排便困难评分、首次排便时间临床指标变化;应用汉化简明健康调查量表(SF-36)对护理前后两组患者的生活质量进行评定;比较两组护理后空腹血糖、糖化血红蛋白指标变化。结果 循证预警护理组每周排便次数显著高于常规护理组,而排便困难评分、首次排便时间显著低于对照组,差异有统计学意义(P<0.05);两组护理后SF-36量表评分均有升高,循证预警护理组护理后SF-36量表中总体健康、精神健康、躯体活力、躯体疼痛、生理职能、生理功能、社会功能、情感职能8项指标评分显著高于常规护理组,差异有统计学意义(P<0.05);循证预警护理组护理后空腹血糖、糖化血红蛋白指标显著低于常规护理组,差异有统计学意义(P<0.05)。结论 脊柱骨折术后患者进行基于循证理念的预警性护理可早期促进排便功能,减少术后腹胀和便秘发生情况及严重程度,提高患者的生活质量,值得临床推广。

Objective To observe the effect of early-warning nursing based on evidence-based concept on postoperative quality of life in patients with spinal fractures complicated with diabetes mellitus.Methods A total of 90 patients with diabetes after spinal fractures who were diagnosed and treated in the First Affiliated Hospital of Xiamen University from May 2019 to March 2020 were selected for clinical selection.According to the random control method,they were divided into routine nursing group(n=45) and evidence-based early warning nursing group(n=45).The routine nursing group received routine nursing methods,and the evidence-based early warning nursing group received early warning nursing based on evidence-based concepts.Both groups received nursing care for 2 weeks.The number of defecation per week,the score of defecation difficulty assessed by visual analog scale,and the changes of clinical indicators of time to first defecation were compared between the two groups after nursing.The quality of life of the patients in the two groups before and after nursing was evaluated by using the simplified Chinese version of the health questionnaire(SF-36).The changes of fasting blood glucose and glycosylated hemoglobin were compared between the two groups after nursing.Results The number of defecation per week in the evidence-based early warning nursing group was significantly higher than that in the routine nursing group,while the score of defecation difficulty and the time to first defecation were significantly lower than those in the routine nursing group,the difference was statistically significant(P<0.05).The scores of SF-36 scale increased after nursing in both groups.In the evidence-based early warning nursing group,the overall health,mental health,physical vitality,physical pain,physiological function,and physiological function were included in the SF-36 after nursing.The scores of eight indicators of social function and emotional function were significantly higher than those of the routine nursing group,and the difference was statistically significant(P<0.05).The fasting blood glucose and glycosylated hemoglobin in the evidence-based early warning nursing group after nursing were significantly lower than those in the routine nursing group,and the difference was statistically significant(P<0.05).Conclusion Early-warning nursing based on evidence-based concept in patients after spinal fracture surgery can promote defecation function early,reduce the occurrence and severity of postoperative abdominal distension and constipation,and improve the quality of life of patients.It is worthy of clinical promotion.