糖尿病肾脏疾病住院患者初诊时的临床分析及护理  

Clinical Characteristics Analysis and Nursing of the Patients with Diabetic Kidney Disease

作　　者：刁永书[1] 黄佑群[1] 马登艳[1] 温月[1] 冯延欢[1] 付平[1] 刘芳[1] 

机构地区：[1]四川大学华西医院肾脏内科,四川成都610041

出　　处：《四川医学》2014年第4期506-509,共4页Sichuan Medical Journal

摘　　要：目的对糖尿病肾脏疾病(DKD)住院患者初次诊断时的临床情况进行分析,为临床治疗护理提供参考。方法收集2003年1月至2008年12月在我院首次诊断为DKD的1242例住院患者的临床资料,并追踪随访,分析相关指标。结果对初诊时为MogensenⅢ、Ⅳ和Ⅴ期的病例进行单因素方差分析发现,糖尿病病程、血红蛋白、白蛋白、肌酐、空腹血糖、餐后血糖、糖化血红蛋白值、平均动脉压、收缩压、舒张压等指标的差异有统计学意义(P<0.05);且血糖值随着分期增加而降低,Ⅲ、Ⅳ期患者血糖控制较差;Ⅴ期患者血压控制最差。护理上应结合患者各期的病情特点,对血压、血糖、饮食及药物治疗进行有效管理和调整,以延缓病情进展,提高生活质量,改善预后。结论早期诊断并结合不同分期患者的临床特点,做好各期DKD患者的护理,提高患者的疾病自我管理能力,可改善患者预后。Objective To investigated the clinical status of patients with diabetic kidney disease （DKD） at first hospitalization, so as to provide reference for clinical nursing practice. Methods Clinical data of 1242 patients with DKD admitted to our hospital from January 2003 through December 2008 were collected, these patients were followed up. The clinical characteristics of these patients were summarized and the relevant indicators were analyzed. Results ANOVA analysis indicated that there was significant difference in diabetic course, levels of hemoglobin, serum albumin, creatine, fasting blood glucose, postprandial hyperglycemia, glyeosylated hemoglobin, mean arterial pressure, systolic pressure and diastolic pressure compared among patients in three Mogensen stages （P 〈 0. 05 ）. And blood glucose level reduced as the Mogensen stage progressed. Poor glycemic control was obvious in patients in Ⅲ and Ⅳ stages, and hypoglycemia happened more frequently in the Ⅴ stage patients. Moreover, poor blood pressure control was also seen in patients at Ⅴ stage. Careful nursing should consider the clinical features of patients in different stages and the effective management of blood pressure,blood glucose should be carried out so as to decelerate the procession and improve the quality of life. Conclusions Early diagnosis and treatment with respective strategies according to the different clinical characteristics ofthe patients in different stages may improve the self-management and the outcome of DKD patients.

关 键 词：糖尿病肾脏疾病 Mogensen分期 临床特点 护理 

分 类 号：R587.2[医药卫生—内分泌]