许红云

[摘要] 目的 探讨持续质量改进对骨折合并糖尿病老年手术患者血糖水平及并发症的影响。 方法 选取2016年1月—2017年9月于该院就诊并行手术治疗的骨折合并糖尿病老年患者80例，采用数字随机法，将患者均分为观察组（n=40）与对照组（n=40），对照组采用基础护理管理，观察组采用持续质量改进干预，对比两组患者的干预情况。结果 观察组干预后的FPG、2 hPG、HbAlc显著低于对照组（P<0.05）；观察组术后24、48、72 hVAS评分显著低于对照组（P<0.05）；观察组切口拆线时间、住院时间显著短于对照组（P<0.05）；观察组术后并发症发生率显著低于对照组（P<0.05）。结论 持续质量改进能够有效控制骨折合并糖尿病老年手术患者的血糖水平，减轻术后疼痛程度，并降低术后并发症发生率，缩短患者的住院时间，促进患者身体康复，可在临床上推广使用。

[关键词] 骨折；糖尿病；血糖；持续质量改进；并发症

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2018）02（a）-0107-03

Analysis of Clinical Effect of Continuous Quality Improvement in the Blood Glucose Control and Complications of Senile Operative Patients with Fractures and Diabetes

XU Hong-yun

Second Department of Orthopedics， Linyi Central Hospital， Linyi， Shandong Province， 276400 China

[Abstract] Objective To study the clinical effect of continuous quality improvement in the blood glucose control and complications of senile operative patients with fractures and diabetes. Methods 80 cases of senile patients with fracture and diabetes for surgical treatment in our hospital from January 2016 to September 2017 were selected and randomly divided into two groups with 40 cases in each， the control group used the basic nursing management， while the observation group used the continuous quality intervention， and the intervention condition was compared between the two groups. Results After intervention， the FPG， 2 hPG， HbAlc in the observation group were obviously lower than those in the control group（P<0.05）， and the 24， 48， 72 hVAS scores in the observation group after surgery were obviously lower than those in the control group（P<0.05）， and the incision clearing time and length of stay in the observation group were shorter than those in the control group（P<0.05）， and the incidence rate of complications after surgery in the observation group was obviously lower than that in the control group（P<0.05）. Conclusion The continuous quality improvement can effectively control the blood glucose level of senile operation patients with fracture and diabetes， relieve the postoperative pains， reduce the incidence rate of complications after surgery， shorten the length of stay and promote the physical recovery， and it is worth clinical promoted and applied.

[Key words] Fracture； Diabetes； Blood glucose； Continuous quality improvement； Complication

由于老年人骨量減少、骨骼脆性增加及骨质疏松，常会因为突发性意外事件导致骨折。糖尿病是常见的老年慢性疾病之一，合并糖尿病会增加骨折老年患者术中危险及术后并发症发生率，影响患者的康复[1]。持续质量改进是以全面质量管理为基础发展而老的持续性、全程性的质量管理，在近年来被广泛应用在医疗管理中，取得了满意的效果[2]。因此，该文给予骨折合并糖尿病老年手术患者持续质量改进进行干预，观察患者的血糖水平及并发症发生情况，以期寻找到理想的干预方法，现报道如下。

1 资料与方法

1.1 一般资料

选取该院就诊并行手术治疗的骨折合并糖尿病老年患者80例作为观察对象，纳入标准：①符合WHO制定的2型糖尿病诊断标准[3]；②经影像学、病理学检查符合骨折诊断标准，60岁以上；③具有手术指征，无手术禁忌证；④征得该院医学伦理委员会同意；⑤与患者或家属签署知情同意书，自愿参与该研究。……