基于个案管理模式护理干预对糖尿病周围神经病变的疼痛状况及神经电生理水平的影响

Influence of nursing intervention based on case management model on pain status and neurophysiological level of diabetic peripheral neuropathy

目的探讨基于个案管理模式护理干预对糖尿病周围神经病变的疼痛状况及神经电生理水平的影响。方法选取2018年6月至2021年6月在杭州市红十字会医院诊治的糖尿病周围神经病变患者80例为研究对象。按照随机数字表法将其分为对照组与研究组,每组各40例。对照组接受常规认知干预及康复护理,研究组在对照组的基础上接受基于个案管理模式的认知干预及康复护理。护理3个月后,比较两组视觉模拟评分法(VAS)评分、多伦多临床神经病变评分(TCSS)、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分,评估两组肌电图检测指标(正中神经、腓总神经感觉传导速度及运动传导速度)及糖尿病相关知识知晓率。结果研究组疼痛缓解率高于对照组,差异有统计学意义(P<0.05)。护理后,两组TCSS、SDS、SAS评分低于护理前,且研究组低于对照组,差异有统计学意义(P<0.05)。护理后,两组正中神经、腓总神经感觉传导及运动传导速度高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。护理后,两组糖尿病相关知识知晓评分高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论基于个案管理模式护理干预应用于糖尿病周围神经病变可显著减轻患者疼痛,并可提升神经传导功能,值得应用推广。

Objective To explore the effect of nursing intervention based on case management model on the pain status and neurophysiological level of diabetic peripheral neuropathy.Methods A total of 80 patients with diabetic peripheral neuropathy who were diagnosed and treated in Hangzhou Red Cross Hospital from June 2018 to June 2021 were selected as the research objects.According to the random number table method,they were divided into control group and research group,with 40 cases in each group.The control group received routine cognitive intervention and rehabilitation nursing,while the study group received cognitive intervention and rehabilitation nursing based on the case management model on the basis of the control group.After three months of nursing,the scores of visual analogue scale(VAS),Toronto clinical neuropathy score(TCSS),self-rating depression scale(SDS)score,and self-rating anxiety scale(SAS)score were compared between the two groups.The EMG detection indicators(median nerve,common peroneal nerve sensory conduction velocity,and motor conduction velocity)and the awareness rate of diabetes-related knowledge were evaluated in the two groups.Results The pain relief rate in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).After nursing,the scores of TCSS,SDS,and SAS in the two groups were lower than those before nursing,while those of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).After nursing,the sensory conduction and motor conduction velocities of the median nerve and common peroneal nerve in the two groups were higher than those before nursing,while those of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).After nursing,the awareness scores of diabetes-related knowledge in the two groups were higher than those before nursing,and the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Nursing intervention based on case management model applied to diabetic peripheral neuropathy can significantly reduce pain and improve nerve conduction function,which is worthy of application and promotion.