专科护士主导的糖尿病足Wagner分级居家随访管理在Wagner 0级糖尿病足患者中的应用  

Application of Wagner grade home follow-up management of diabetic foot led by specialist nurses in Wagner 0 diabetic foot patients

作　　者：张洁[1] 海洁[2] 屈自如 郭岭岭[1] 张彦彦 Zhang Jie;Hai Jie;Qu Ziru;Guo Lingling;Zhang Yanyan(Second Ward of General Medicine Department&First Ward of Integrated Traditional Chinese and Western Medicine&Department of Traditional Chinese Medicine,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China;First Ward of General Medicine Department&First Ward of Endocrinology Department,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院全科医学科二病区、中西医结合科一病区、中医科,新乡453100 [2]新乡医学院第一附属医院全科医学科一病区、内分泌一病区,新乡453100

出　　处：《中华现代护理杂志》2021年第20期2729-2734,共6页Chinese Journal of Modern Nursing

基　　金：二〇一九年度新乡医学院第一附属医院护理科研培育基金项目(2019-HLPY-B003);2018年度河南省社科联、河南省经团联调研课题项目(SKL-2018-2070)。

摘　　要：目的:探讨专科护士主导的糖尿病足Wagner分级居家随访管理的应用效果。方法:采用便利抽样法选择2017年1月—2018年12月在新乡医学院第一附属医院内分泌科住院的241例2型糖尿病且Wagner 0级糖尿病足患者,按照入组时间将2017年1—12月入组的113例Wagner 0级糖尿病足患者设为对照组,将2018年1—12月入组的128例Wagner 0级糖尿病足患者设为观察组。对照组实施常规居家护理管理,观察组实施专科护士主导的糖尿病足Wagner分级居家随访管理。两组均管理随访18个月。比较两组的血糖指标、糖尿病自我管理行为量表(SDSCA)得分及足部预后。结果:干预后观察组的空腹血糖和糖化血红蛋白水平低于对照组,且较干预前降低;SDSCA得分高于对照组,且较干预前升高,差异均有统计学意义(P<0.05)。第6个月末,观察组暂无4、5级患者,0~1级人数多于对照组,2~3级人数少于对照组,差异有统计学意义(P<0.05);第12、18个月末,观察组的0~1级人数多于对照组,2~3、4~5级人数少于对照组,差异有统计学意义(P<0.05)。第18个月末,两组患者均无死亡病例,对照组6例患者手术治疗,1例截肢;观察组1例手术治疗,无截肢患者。结论:专科护士主导的糖尿病足Wagner分级居家随访管理可以有效改善患者的血糖控制水平,提高自我管理能力,并延缓糖尿病足进展。Objective To explore the effect of Wagner grade home follow-up management of diabetic foot led by specialist nurses.Methods From January 2017 to December 2018,convenience sampling was used to select 241 patients with type 2 diabetes and Wagner grade 0 diabetic foot in the Endocrinology Department of the First Affiliated Hospital of Xinxiang Medical University.According to the enrollment time,113 patients with Wagner grade 0 diabetic foot enrolled from January to December 2017 were set as the control group,and 128 patients with Wagner grade 0 diabetic foot enrolled from January to December 2018 were set as the observation group.The control group implemented routine home care management,and the observation group carried out the Wagner grade home follow-up management of diabetic foot led by specialist nurses.Both groups were followed up for 18 months.The blood glucose index,Scale of the Diabetes Self-care Activities(SDSCA)score and foot prognosis were compared between the two groups.Results After the intervention,the fasting blood glucose and glycosylated hemoglobin of the observation group were lower than those of the control group,and lower than those before the intervention,and the SDSCA score was higher than that of the control group,and higher than that before the intervention,the differences were statistically significant(P<0.05).At the end of the sixth month,the observation group had no patients in grade 4 and grade 5,had more people in grade 0 to 1 than in the control group,and fewer people in grade 2 to 3 than in the control group,and the difference was statistically significant(P<0.05).At the end of the twelfth and eighteenth months,the observation group had more people in grades 0 to 1 than in the control group,and fewer in grades 2 to 3 and 4 to 5 than in the control group,and the difference was statistically significant(P<0.05).At the end of the eighteenth month,there were no deaths in the two groups,and 6 patients with surgery,and 1 patient with amputation in the control group,and 1 patient with surger

关 键 词：糖尿病 2型 糖尿病足 专科护士 自我管理能力 足部预后 

分 类 号：R473.5[医药卫生—护理学]