程瑾璇

[摘要] 目的 探讨老年妇科肿瘤合并糖尿病围手术期护理的方法及效果。 方法 按照随机数字表法将我院收治的84例老年妇科肿瘤合并糖尿病患者均分为实验组和对照组，对照组患者给予传统护理，实验组患者给予新式护理，比较两组患者的治疗情况、血糖控制情况以及血糖控制良好者血糖情况。 结果 两组患者平均手术时间、地塞米松平均使用时间、地塞米松平均使用剂量及胰岛素平均使用剂量比较，差异均无统计学意义（P>0.05）；实验组患者血糖控制良好率显著高于对照组，血糖>20 mmol/L和追加胰岛素发生率显著低于对照组，差异有统计学意义（P<0.05）；实验组患者血糖控制良好所用时间显著低于对照组，差异有统计学意义（P<0.05）；两组血糖控制良好者平均血糖水平和血糖波动水平比较，差异均无统计学意义（P>0.05）。 结论 实施新式护理可有效提高老年妇科肿瘤合并糖尿病围手术期血糖控制效果，缩短血糖控制良好所用时间，临床效果显著。

[关键词] 老年；妇科肿瘤；糖尿病；围手术期；护理

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2015）08-0147-03

[Abstract] Objective To explore the clinical effects of new nursing for the patients with elderly gynecologic tumor combine with diabetes. Methods All 84 cases of patients with pynecological malignant tumor in patients complicated with diabetes were divided into experiment group and control group. The control group were cared by traditional nursing， while the experiment group were cared by new nursing. The treatment condition， blood sugar control situation and glycemic control blood sugar were compared between two groups. Results There were no significant differences on the mean operating time， mean use time for dexamethasone， mean using dose dexamethasone and average use insulin doses（P>0.05）； The rate of blood glucose control of the experiment group was higher than that of the control group（P<0.05）； The rate of blood glucose>20 mmol/L and supplemental insulin of the experiment group were lower than those of the control group（P<0.05）； The time of good blood glucose control of the experiment group was lower than that of the control group（P<0.05）； There were no significant differences on the levels of blood glucose and the levels of glucose fluctuation（P>0.05）. Conclusion New nursing has good effects of blood glucose management in patients with elderly gynecologic tumor combine with diabetes， it can cut down the time of blood sugar control used in good time. The clinical curative effect is distinct.

[Key words] Old age； Gynecological oncology； Diabetes mellitus； Perioperative period； Nursing

妇科恶性肿瘤严重威胁女性健康，老年妇女因身体机能和免疫功能逐渐下降，恶性肿瘤发病率较高[1]。目前，手术切除是治疗妇科恶性肿瘤的主要临床手段，老年人因多存在糖尿病、高血压、高血脂症等慢性疾病增加了手术治疗的难度[2]。临床研究表明，围术期血糖控制的效果可对老年妇科肿瘤合并糖尿病患者的治疗和预后效果产生较大影响[3]。我院在老年妇科肿瘤合并糖尿病围手术期传统护理的基础上实施新式护理，取得了较为满意的临床效果，现对护理效果进行分析，现报道如下。