护理干预对糖尿病肾病早期诊断的影响  

Effect of nursing intervention in improving early diagnosis of diabetic nephrosis

作　　者：罗春娥[1] 甘柳萍[2] 梁毅玲[3] 黄向阳[1] 覃惠星[1] 张锦龙[2] 

机构地区：[1]广西医科大学第四附属医院肾内科,柳州545005 [2]广西医科大学第四附属医院耳鼻喉科,柳州545005 [3]广西医科大学第四附属医院护理部,柳州545005

出　　处：《中华现代护理杂志》2010年第35期4247-4250,共4页Chinese Journal of Modern Nursing

基　　金：广西壮族自治区卫生厅计划项目（Z2008367）

摘　　要：目的 通过护理干预阻断或延缓糖尿病肾病（DN）患者的进程,减少终末期肾衰竭的发生.方法 利用世界肾脏病日、世界糖尿病日、＂5·12＂护士节等公益活动,或不定期到社区为非住院的社区糖尿病患者进行DN防治知识的卫生宣教,普及DN的防治知识,通过进行尿微量白蛋白检测,当尿常规检测蛋白定性为阴性,尿微量白蛋自在20～200μg/min或30～300 mg/24 h（正常人＜10 μg,/min）时,定为早期DN;当尿常规检测蛋白定性为阳性,尿微量白蛋白＞200μg/min或300mg/24 h定为临床性DN,两组间均进行饮食、降血压、降血糖、降血脂等护理干预,比较两组间肾脏的逆转及损害的进展情况.结果 两组DN患者护理干预前对DN相关知识的认知程度差异无统计学意义（P＞0.05）,通过护理干预后,早期DN组尿微量白蛋白下降及肾脏损害逆转明显高于对照组,两组比较差异有统计学意义（P＜0.01）.结论 为阻断或延缓DN的进程,减少终末期肾衰竭的发生,普及DN的防治知识,提高防治意识,定期进行尿微量白蛋白检测是关键所在.Objective To block or postpone the process of diabetic nephrosis （DN） by nursing intervention and reduce the occurrence of final stage of renal failure. Methods Health education on DN prevention and treatment was implemented in the public benefit activities on World Renal Disease Day, World Diabetes Day and Nurses＇ Day and among the non-hospitalized diabetes patients in the community irregularly.Early DN would be diagnosed if urinary protein test was negative and urinary mALB was 20 ～200 μg/min or 30 ～ 300 mg/24 h （the normal value is less than 10 μg/min）. Clinical DN would be diagnosed if urinary protein test was positive and urinary mALB was more than 200 μg/min or 300 mg/24 h. Both groups received nursing intervention of diet and controlling blood pressure, blood glucose and blood lipid. The reversion of nephrosis and lesion were compared between the two groups after intervention. Results There was no significant difference in awareness of DN knowledge between the two groups （P 〉 0. 05） before intervention. Patients with early DN obtained better reversion of nephrosis and lower urinary mALB than those with clinical DN. There was significant difference between the two groups after intervention （P 〈 0. 01）. Conclusions The occurrence of final renal failure will be reduced if DN process is blocked or postponed. The publicity of knowledge of DN prevention and treatment, improvement of the awareness and regular test of urinary mALB are most important.

关 键 词：糖尿病肾病 护理干预 早期诊断 

分 类 号：R473.5[医药卫生—护理学]