强化自能护理在糖尿病肾病行腹膜透析患者中的应用

Application of Enhanced Self-care among the Patients with Diabetic Nephropathy Undergoing Peritoneal Dialysis

目的分析强化自能护理在糖尿病肾病(DN)行腹膜透析患者中的应用价值。方法选取行腹膜透析DN患者69例,随机分为干预组35例和对照组34例,均予以DN常规护理,干预组在此基础上增加强化自能护理措施。干预前及干预后3个月,观察两组自我管理能力、容量负荷情况及糖代谢指标的变化。结果干预后3个月,干预组在运动、具体饮食、总体饮食及血糖监测方面的评分较干预前明显增加,而体质量、收缩压、舒张压及透析液超滤量明显降低,且上述各指标均显著高于/低于对照组,差异有统计学意义(P<0.05)。干预后3个月,两组空腹血糖(FBG)、餐后2 h血糖(2h PG)和糖化血红蛋白(Hb A1c)水平均较干预前明显降低(P<0.05),但干预组降低幅度更为显著(P<0.05)。结论对DN行腹膜透析患者实施强化自能护理有助于提高自我管理能力,改善容量负荷状态,控制血糖水平。

OBJECTIVE To investigate the application value of enhanced self-care in the patients with diabetic nephropathy(DN)undergoing peritoneal dialysis. METHODS Totally 69 DN patients undergoing peritoneal dialysis were randomly assigned into interven-tion group(n=35) and control group(n=34). Both groups were given DN routine nursing, and based on this, the intervention group wasadded enhanced self-care measures. The changes of self-management ability, volume load and glycometabolism indexes were ob-served between two groups before and 3 months after intervention. RESULTS Compared with before intervention, the scores of exer-cise, specific and total diets as well as glucose monitoring in intervention group 3 months after intervention went up, while the bodyweight, systolic pressure, diastolic pressure and dialysate ultrafiltration volume down markedly. All the above-mentioned indexes in in-tervention group were significantly higher or lower than those in control group(P<0.05). Compared with before intervention, the lev-els of fasting blood glucose(FBG), 2-h postprandial glucose(2 h PG) and glycosylated hemoglobin(Hb A1 c) in both groups decreasedobviously 3 months after intervention(P<0.05), but the decreased range in intervention group was more significant(P<0.05). CONCLUSION Application of enhanced self-care in DN patients undergoing peritoneal dialysis was conductive to improve self-manage-ment ability and volume load condition and control blood glucose.