多学科协作模式在老年糖尿病患者护理中的应用  

Application of multidisciplinary treatment mode in the nursing care of elderly diabetic patients

作　　者：杨艳[1] 赵琨[1] 吕娅 尹星[1] 赵明[1] 邵加庆[3] 张芳[1] 倪娟[3] 朱小尉 

机构地区：[1]南京军区南京总医院干部病区,南京210002 [2]江苏省军区门诊部,南京210009 [3]南京军区南京总医院内分泌科,南京210002 [4]南京军区南京总医院保健办,南京210002

出　　处：《医学研究生学报》2016年第12期1318-1320,共3页Journal of Medical Postgraduates

摘　　要：目的老年糖尿病的治疗对良好整体的护理措施有着很高的要求,文中旨在探讨多学科协作模式(multidisciplinary treatment,MDT)在老年糖尿病患者护理中的应用价值。方法选取符合WHO诊断标准的老年糖尿病患者200例,MDT组105例,对照组95例,对照组采用常规护理,MDT组在常规护理基础上联合糖尿病专科、老年病科、心血管科、营养科等多专科协作团队,各自到岗履行职责共同护理患者。制定个性化护理方案,以专科为主,定期组织会诊根据患者情况及时调整护理方案,由入院至出院后随访3个月。观察2组患者住院时间、费用、糖尿病并发症的发生以及护理满意度。结果MDT组住院时间和住院费用均显著低于对照组分别为[(8.2±1.7)vs(13.5±3.5)d和(42 067.7±6 372.1)vs(50 236.8±9 587.5)元],差异有统计学意义(P<0.05);MDT组的患者满意度高于对照组(95.2%vs 86.3%),(P<0.01);MDT组并发症的发生率为9.5%(高血糖占3.8%,低血糖占1%,跌倒占1%,局部褥疮占1%)较对照组38.9%(高血糖占11.5%,低血糖占4.2%,跌倒占6.3%,局部褥疮占6.3%)明显降低,差异有统计学意义(P<0.05)。结论 MDT运用到老年糖尿病护理中,优于传统的常规护理模式,缩短了患者住院时间及住院费用、延缓并发症的发生发展并提高患者及其家属的护理满意度,进而改善长远预后,提高老年糖尿病患者生活质量。Objective The treatment of senile diabetes requires overall good care measurements. The article aimed to explore the role of multidisciplinary treatment（ MDT） in the nursing care of elderly diabetic patients. Methods 200 cases of elderly patients with diabetes in line with WHO diagnostic criteria were selected and divided into MDT group（ra= 105） and control group（n = 95 ca-ses）. Patients in control group received routine care, and patients in MDT group received MDT nursing care from collaborative teams of geriatrics, cardiology, nutrition and other specialists on the basis of routine care. We designed personalized care plan, organized regularconsultation based on specialized nursing and adjusted nursing plan timely according to patients＇ situation. We also provided 3 months of follow-up to observe the patients＇ hospitalization time, costs, inci-dence of diabetes complications and nursing satisfaction. Results The length of stay and hospitalization costs of MDT group were signifi-cantly lower than those of control group [ （ 8 .2± 1 .7 ） vs （ 13.5 ± 3 .5） vs （ 4 2 067 .7±6372.1） vs （ 502 36.8±9587.5） yuan, P 〈 0 .0 5 ] . Thepatient satisfaction of MDT group was higher than that of control group （ 95.2% vs 86.3% , P〈0 .0 1） . As to the diabetes complications, the incidence of MDT group was 9.5% （ 3.8% high blood sugar, 1% low blood sugar, 1% fall and 1% partial bedsore） , while the inci-dence of control group was 17.8% （ 11.5% high blood sugar, 4.2% low blood sugar, 6.3% fall and 6.3% partial bedsore） , showing significant difference（P〈0.05）. Conclusion The application of MDT in the elderly diabetic care is superior to traditional nursing mode, which shortens the length of stay and hospitalization costs, delays the development of complications and improve the satisfaction of patients and their families, thereby improving the long-term prognosis and the lif

关 键 词：糖尿病 多学科协作 综合治疗 老年患者 

分 类 号：R587.1[医药卫生—内分泌]