丛芳 胡平平

[摘要] 目的 观察综合护理措施控制膝关节置换术老年糖尿病患者的血糖的应用效果。方法 2015年1月—2016年12月62例行膝关节置换术的患者随机分为观察组和对照组，各31例。对照组患者行常规护理措施，观察组患者行综合护理干预。检测患者护理干预前后的血糖指标，评价髋关节功能，记录相关并发症发生率。结果 两组患者FBG、2 hPG、HbAlc与治疗前相比都有明显下降（P<0.05），观察组患者各项指标的降低幅度高于对照组（P<0.05）。观察组患者髋关节功能优良率（87.10%）高于对照组（70.96%）（P<0.05）。观察组患者术后并发症总发生率（9.68%）低于对照组（22.58%）（P<0.05）。结论 于老年糖尿病患者行膝关节置换术中予以患者综合护理措施能有效控制患者血糖水平，降低术后相关并发症的发生率，并改善患者髋关节功能。

[关键词] 老年糖尿病;膝关节置换术;综合护理;血糖

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1672-4062（2019）06（b）-0015-03

[Abstract] Objective To observe the effect of comprehensive nursing measures on the control of blood glucose in elderly patients with diabetes mellitus. Methods Sixty-two patients from January 2015 to December 2016 undergoing knee arthroplasty were randomly divided into observation group and control group， 31 cases each. Patients in the control group underwent routine nursing measures， and patients in the observation group underwent comprehensive nursing intervention. Blood glucose indicators before and after patient care intervention were measured， hip function was evaluated， and the incidence of related complications was recorded. Results The FBG， 2 hPG and HbAlc of the two groups were significantly lower than those before treatment（P<0.05）. The decrease of each index in the observation group was higher than that of the control group（P<0.05）. The excellent rate of hip function in the observation group（87.10%） was higher than that in the control group （70.96%）（P<0.05）. The total incidence of postoperative complications （9.68%） was lower in the observation group than in the control group （22.58%）（P<0.05）. Conclusion Comprehensive nursing measures for elderly patients with diabetes undergoing knee arthroplasty can effectively control blood glucose levels， reduce the incidence of postoperative complications， and improve hip function.

[Key words] Elderly diabetes; Knee replacement; Comprehensive care; Blood glucose

膝關节病变是以关节软骨面退行性变和继发性骨质增生为病理基础的骨科疾病。膝关节置换术是膝关节病变临床治疗的常用方法，但针对合并糖尿病的老年患者，血糖水平是影响患者手术效果、术后并发症的发生率及预后的重要因素。而临床上予以患者有效的护理干预措施是控制患者血糖水平的关键环节，该文2015年1月—2016年12月探讨了综合护理服务对行膝关节置换术治疗的31例老年糖尿病患者的效果，现做如下报道。

1  资料与方法

1.1  一般资料

选取在该院就诊的62例行膝关节置换术治疗的患者为研究对象，所有患者均经关节镜、MRI等影像学检查确诊。其中男36例，女26例;年龄60～76岁，平均（68.35±5.23）岁;股骨颈骨折21例，股骨头缺血性坏死37例，骨性关节炎4例;病程3～18年，平均（8.72±2.45）年;术前美国特种外科医院膝关节评分（HSS）36～54分，平均（47.26±5.56）分。采用随机数字表法分成观察组和对照组，各31例，两组一般资料对比差异无统计学意义（P>0.05）。所有患者知情同意，且该研究得到医院医学伦理委员会批准。