糖尿病足风险分级管理在上海郊区糖尿病患者中的应用  

Application of Risk Grading Management on Diabetic Foot for Diabetic Patients in Suburbs of Shanghai

作　　者：许华娇 沈英[1] 黄建芬[1] 何晓玲[1] 邢蕾蕾 XU Huajiao;SHEN Ying;HUANG Jianfen;HE Xiaoling;XING Leilei(Jinshan Hospital,Fudan University,Shanghai 201508)

机构地区：[1]复旦大学附属金山医院,上海201508

出　　处：《上海护理》2020年第6期5-9,共5页Shanghai Nursing

基　　金：上海市金山区卫生和计划生育委员会科研课题项目(JSYQ201609)。

摘　　要：目的探讨糖尿病足风险分级管理在上海市郊区部分2型糖尿病患者中的应用效果。方法采用便利抽样法,选取2017年1—6月在复旦大学附属金山医院内分泌科住院治疗的2型糖尿病患者120例,采用简单随机化分组分为观察组(n=60)、对照组(n=60)。对照组患者予以常规治疗、口头健康教育及门诊随访,观察组患者由糖尿病专科护士根据其糖尿病足危险等级施以对应的健康教育分级管理。随访1年后,比较两组糖尿病患者的足部护理知识、足部护理行为水平以及糖尿病足风险等级情况。结果研究过程中脱落样本14例,最终纳入分析对照组50例、观察组56例。观察组患者的足部护理知识在随访半年及1年后均高于对照组(P<0.05);教育后、随访半年及1年后,观察组患者足部护理行为得分均高于对照组(P<0.05);足部护理知识及行为水平在组别与时间的交互作用均具有统计学意义(P<0.05)。两组患者在入组时、随访半年后、随访1年后糖尿病足危险等级构成比未呈现统计学差异(P>0.05);随访1年后,观察组患者踝-肱指数高于对照组(P<0.05),观察组中、高危足下降率高于对照组(P<0.05)。结论对上海市郊区2型糖尿病患者实施糖尿病足风险分级管理,可提高糖尿病患者足部护理知识及行为水平,改善其周围血管病变情况,降低糖尿病足风险等级及糖尿病足的发生率。Objective To explore the effect of risk grading management on diabetic foot for type 2 diabetic patients in suburbs of Shanghai.Methods A total of 120 type 2 diabetic patients who were hospitalized in the Department of Endocrinology,Jinshan Hospital of Fudan University from January to June 2017 were selected by convenience sampling method.They were divided into observation group(n=60)and control group(n=60)by using simple randomization.The patients in the control group were given routine treatment,oral health education and outpatient follow-up,while the patients in the observation group were given corresponding heath education management by the diabetes specialist nurses according to their risk levels of diabetic foot.After 1 year of follow-up,the foot care knowledge,the level of foot care behavior,and the risk level of diabetic foot were compared between the two groups.Results During the study,14 samples were dropped,and finally 50 cases were enrolled into the control group and 56 cases were enrolled into the observation group for analysis.The foot care knowledge of the patients in the observation group was superior than that in the control group after 6-month and 1-year follow-up respectively(P<0.05);the scores of foot care behavior of the patients in the observation group were higher than those of the patients in the control group after education,6-month and 1-year follow-up respectively(P<0.05);the foot care knowledge and behavior level were statistically different in the interaction between group and time(P<0.05).There was no statistical difference in the risk constituent ratio of diabetic foot between the two groups at enrollment,after 6-month follow-up and 1-year followup(P>0.05);after 1-year follow-up,the ankle-brachial index in the observation group was higher than that in the control group(P<0.05),and the decrease rate of medium and high-risk diabetic foot in the observation group was higher than that in the control group(P<0.05).Conclusion The implementation of risk grading management on diabetic foot

关 键 词：2型糖尿病 糖尿病足 风险分级 足部护理 健康教育 

分 类 号：R473.58[医药卫生—护理学]