| 笃铭丽,周意,方芳.围手术期护理干预对糖调节受损患者行CABG术效果研究[J].上海护理,2015,15(7): |
| 围手术期护理干预对糖调节受损患者行CABG术效果研究 |
| Effect of integrated nursing interventions implemented for patients accepting CABG with impaired glucose regulation during their perioperative period .Du Ming-li,Zhou Yi ,Fang Fang.Shanghai First People’s Hospital, Shanghai 200080,China |
| 投稿时间：2014-10-12 修订日期：2015-02-12 |
| DOI： |
| 中文关键词: 围手术期 护理 糖调节受损 CABG 血糖 效果 |
| 英文关键词:Perioperative Period nursing Impaired Glucose Regulation CABG |
| 基金项目:上海交通大学附属第一人民医院院级科研基金11A08 |
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| 中文摘要: |
| 目的 探讨围手术期护理干预对糖调节受损患者行CABG术的效果。 方法 将2012年5月至2013年10月进行冠脉搭桥符合糖调节受损诊断标准的患者90例随机分为观察组（n=45）和对照组（n=45），对照组接受常规护理，观察组按照一定的护理标准进行围手术期护理干预，比较患者血糖波动情况、术后并发症的发生及患者冠心病康复与糖尿病预防知识掌握程度、患者满意度。结果 冠状动脉搭桥术当天、术后
第1天、术后第2天两组患者平均血糖水平比较差异无统计学意义（P＞0.05），术后第3天两组患者平均血糖水平比较差异有统计学意义（P＜0.05），观察组低于对照组患者；在血糖水平的标准差方面比较，手术当天两组患者比较差异无统计学意义（P＞0.05），术后第1～3天两组患者比较差异有统计学意义（P＜0.05），观察组患者血糖波动低于对照组患者；冠状动脉搭桥术后两组患者并发症发生情况：术后共有3例患者死亡，死
亡原因为低心排、多脏器功能衰竭。两组患者在死亡、二次手术、IABP应用、房颤、低心排、肾功能不全、肺部感染、MODS等方面比较差异无统计学意义（P＞0.05），在低血糖发生及切口感染方面差异有统计学意义（P＜0.05），对照组低血糖的发生及切口感染发生率要高于观察组患者；观察组患者在冠心病康复与糖尿病预防知识掌握程度及患者满意度的方面得分要高于对照组患者，差异有统计学意义（P＜0.05）。 结论 对于行CABG术的糖调节受损患者进行围手术期血糖方面的护理干预，可以帮助降低患者血糖波动幅度、减少低血糖及切口感染的发生、提高患者冠心病康复与糖尿病预防知识掌握程度及患者满意度。 |
| 英文摘要: |
| Objective: To evaluate the effect of integrated nursing interventions implemented for patients accepting CABG with impaired glucose regulation during their perioperative period. Design: 90 patients underwent CABG who met the impair glucose criterion were recruited. They were randomly allocated into experimental group (n=45) and control group (n=45).The control group underwent routine nursing, while the experimental group accepted standard nursing protocol during the perioperative period. Data of the glucose level, incidence of postoperative complication, knowledge of the disease and satisfaction of patients was collected and compared. Results: The average glucose level of experimental group was lower than the control group on the third day after operation with smaller fluctuation range(P＜0.05). The data had no statistically significant difference on the incidence of postoperative complication between the two groups(P＞0.05).While lower incidence of hypoglycemia and incision infection in the experimental group was supported. Furthermore, patients in the experimental group had better understanding of the knowledge about diabetes and coronary heart disease and higher satisfaction(P＜0.05). Conclusions: Implementing standard glucose control nursing intervention could help patients undergoing CABG during their perioperative period. It could help them to control their glucose varying within certain smaller range and consequently reduce the incidence of hypoglycemia and incision infection. Furthermore, it was beneficial for increasing the knowledge and satisfaction of patients. |
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