程燕

【摘要】 目的 分析和評价院外跟踪护理对肺结核合并糖尿病患者自我管理水平的影响。方法 50例肺结核合并糖尿病患者， 随机分成A组（26例）和B组（24例）。A组给予院外跟踪护理， B组给予常规护理。对比两组自我效能及心理状态评分、血糖控制情况、自护行为情况、痰菌转阴率与症状消失时间。

结果 A组的自我效能评分为（31.25±1.54）分， 高于B组的（25.64±2.67）分， 焦虑评分为（32.57±2.66）分

与抑郁评分为（41.06±4.12）分， 低于B组的（39.49±3.05）、（48.66±3.06）分， 差异均具有统计学意义（P<0.05）。A组血糖控制良好率为92.31%， 高于B组的70.83%， 差异具有统计学意义（P<0.05）。A组的自律运动、正确用药、良好控制饮食、定期复诊、并发症有效预防和正确监测血糖等自护行为达标率（92.31%、88.46%、84.62%、96.15%、88.46%、84.62%）均高于B组（66.67%、62.50%、54.17%、70.83%、50.00%、58.33%）， 差异均具有统计学意义（P<0.05）。A组痰菌转阴率为71.43%， 高于B组的40.91%， 差异有统计学意义（P<0.05）。A组症状消失时间为（26.31±5.33）d， 短于B组的（47.25±7.55）d， 差异有统计学意义（P<0.05）。结论 院外跟踪护理能够提高肺结核合并糖尿病患者的自我管理能力， 使其自护意识得到增强， 值得推广。

【关键词】 院外跟踪护理；肺结核；糖尿病；自我管理水平

DOI：10.14163/j.cnki.11-5547/r.2017.12.078

【Abstract】 Objective To analyze and evaluate influence by out-of-hospital follow-up nursing on self-management level in pulmonary tuberculosis complicated with diabetes patients. Methods A total of 50 pulmonary tuberculosis complicated with diabetes patients were randomly divided into group A （26 cases） and group B （24 cases）. Group A received out-of-hospital follow-up nursing， and group B received conventional nursing. Comparison was made on self-efficacy score， psychological states score， blood glucose control， self-care behavior， sputum bacterium negative conversion rate， and symptom disappearance time between the two groups. Results Group A had higher self-efficacy score as （31.25±1.54） points than （25.64±2.67） points in group B， and it had lower anxiety score as （32.57±2.66） points and depression score as （41.06±4.12） points than （39.49±3.05） and （48.66±3.06） points in group B. Their differences all had statistical significance （P<0.05）. Group A had higher good rate of blood glucose control as 92.31% than 70.83% in group B， and the difference had statistical significance （P<0.05）. Group A had all higher self-care behavior standard reaching rate of self-discipline activity， correct medication， good diet control， regular reexamination， effective complications prevention and correct blood glucose monitoring （92.31%， 88.46%， 84.62%， 96.15%， 88.46%， 84.62%） than the control group （66.67%， 62.50%， 54.17%， 70.83%， 50.00%， 58.33%）， and their differences all had statistical significance （P<0.05）. Group A had higher sputum bacterium negative conversion rate as 71.43% than 40.91% in group B， and the difference had statistical significance （P<0.05）. Group A had shorter symptom disappearance time as （26.31±5.33） d than （47.25±7.55） d in group B， and their difference had statistical significance （P<0.05）. Conclusion Out-of-hospital follow-up nursing can improve self-management ability in pulmonary tuberculosis complicated with diabetes patients， along with enhanced self-care awareness. This method is worth promoting.

【Key words】 Out-of-hospital follow-up nursing； Pulmonary tuberculosis； Diabetes； Self-management level

肺结核合并糖尿病具有病程长、病情复杂、治疗周期长等特点， 需要患者长时间在院外进行治疗[1-4]。由于患者对疾病监测、控制能力较弱， 所以常会出现治疗效果不佳等情况[2]。由此， 提高患者的自我管理水平成为该病有效治疗的首要途径。有学者认为， 院外跟踪护理能够提高患者的自护意识[5]， 但相关报道较少。本文旨在分析院外跟踪护理对肺结核合并糖尿病患者自我管理水平的影响， 现报告如下。……