院外心理干预在2型糖尿病患者首次胰岛素治疗中的应用  

Application of out-of-hospital psychological interventions in treatment of D2TM patients with initial insulin therapy

作　　者：王月萍[1] 徐青华[1] 陆群[1] 许岚[1] 黄溢[1] 陆浩慧[1] 

机构地区：[1]江苏省无锡市人民医院内分泌科,江苏无锡214023

出　　处：《实用临床医药杂志》2016年第16期64-67,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11528509)

摘　　要：目的探讨院外心理干预在2型糖尿病患者初次使用胰岛素治疗中的应用情况。方法首次胰岛素治疗的2型糖尿病患者158例,随机分为观察组与对照组,各79例。对照组常规护理,观察组在对照组基础上实施院外心理干预,定期随访1年,并于3个月、6个月、12个月末时观察2组患者使用胰岛素治疗情况,评估2组胰岛素用量、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)及心理状况。结果 2组随访3个月、6个月和12个月后,胰岛素注射规范、轮换部位、针头一次性使用例数较开始治疗时均有所下降,且注射不良反应均有发生,观察组的总体情况优于对照组,但差异无统计学意义(P>0.05);2组各时间点FPG、Hb A1c较初始治疗时均有所下降(P<0.05),且观察组同期下降显著优于对照组(P<0.05)。观察组胰岛素用量较初始治疗时有所下降,对照组有所上升,2组同期比较差异具有统计学意义(P<0.05);2组各时间点焦虑自评量表(SAS)和抑郁自评量表(SDS)评分较出院时均有所下降(P<0.05),且观察组同期评分显著低于对照组(P<0.05)。结论院外心理护理干预有助于改善首次胰岛素治疗糖尿病患者焦虑抑郁情绪,利于血糖的控制和减少不良反应的发生。Objective To explore the application of out-of-hospital psychological interven- tions in the treatment of type 2 diabetes mellitus （T2DM） patients with initial insulin therapy. Meth- ods A total of 158 T2DM patients with initial insulin therapy were randomly divided into observation group and control group, 79 cases in each group. Control group was given routine nursing, while ob- servation group was given out - of - hospital psychological interventions on the basis of control group. All the patients received 1-year follow up regularly. The insulin dosage, fasting plasma glucose （FPG）, glycosylated hemoglobin （HbAlc） and psychological status of both groups were evaluated at the end of 3,6 and 12 months. Results After 3,6 and 12 months, the number of patients with spec- ified insulin injection, a｜temating sites and disposable used of syringe needle decreased more signifi- cantly than that in initial treatment, and adverse reactions associated with insulin injection were ob- served in all patients. However, observation group was superior to control group in total conditions, but there was no significant difference （ P 〉 0.05 ）. FPG and HbA1 c decreased more significantly at each time point than those in initial treatment in both groups （P 〈 0.05 ） , which decreased more sig- nificantly in observation group than those in control group in the corresponding period （P 〈 0.05 ）. In- sulin dosage decreased significantly in observation group but increased significantly in control group af ter treatment than that in initial treatment, and there were significant differences （ P 〈 0.05 ）. Scores of self - rating anxiety scale （ SAS ） and self - rating depression scale （ SDS ） decreased significantly inboth groups at discharge （ P 〈 0.05 ）, which were also significantly lower in observation group than those in control group in the corresponding period （P 〈 0.05 ）. Conclusion Out-of-hospital psy- chological interventions can effectively improve the anxiety and dep

关 键 词：糖尿病 胰岛素 心理干预 焦虑 抑郁 

分 类 号：R473.5[医药卫生—护理学]