杨翠萍 高欢玲 王芳

[摘要] 目的 探討延续性护理对早期2型糖尿病患者自我管理、血糖水平和血糖波动的影响。 方法 将2018年1月～2019年9月山西省汾阳医院尚无慢性并发症的2型糖尿病住院患者100例随机分为观察组和对照组，观察组患者出院后以电话、入户随访结合微信平台持续护理，对照组患者出院后进行常规电话随访，6个月后评价患者自我管理行为得分及得分率、血糖水平和血糖波动。 结果 观察组干预后自我管理行为总分及得分率、各维度得分及得分率均高于对照组，糖化血红蛋白、空腹血糖、餐后血糖和血糖波动指标（血糖水平标准差、空腹血糖变异系数、餐后血糖漂移幅度）均低于对照组，差异有统计学意义（P<0.05）。 结论 延续性护理可提高2型糖尿病患者的自我管理能力，平稳控制血糖，减少或延缓糖尿病并发症的发生。

[关键词] 糖尿病;2型;延续性护理;血糖波动;自我管理

[中图分类号] R473.5          [文献标识码] B          [文章编号] 1673-9701（2020）17-0179-04

The effect of continuous nursing on self-management and blood glucose regulation of patients with early type 2 diabetes mellitus

YANG Cuiping1   GAO Huanling1   WANG Fang2

1.Department of Nursing， Fenyang College of Shanxi Medical University， Fenyang   032200， China; 2.Department of Endocrinology， Shanxi Fenyang Hospital， Fenyang   032200， China

[Abstract] Objective To explore the effect of continuous nursing on self-management， blood glucose level（BGL） and blood glucose fluctuation （BGF） of patients with early type 2 diabetes mellitus （DM）. Methods 100 hospitalized patients with type 2 DM who had no chronic complications in Fenyang Hospital of Shanxi Province from January 2018 to September 2019 were randomly divided into the observation group and the control group. The patients in the observation group received continuous nursing through telephone and home follow-up combined with WeChat platform after discharge from the hospital， while the patients in the control group received routine telephone follow-up after discharge from the hospital. The scores and scoring rate of self-management behavior， BGL and BGF of the patients were evaluated after 6 m. Results After intervention， the total scores and scoring rate of self-management behavior， scores and scoring rate of all dimensions of the observation group were all higher than those of the control group， and the glycosylated hemoglobin （GHb）， fasting blood glucose， postprandial blood glucose and BGF indexes （standard deviation of BGL， coefficient of variation of fasting BG， and PPGE） were all lower than those of the control group， with statistically significant differences（P<0.05）. Conclusion Continuous nursing can improve the self-management ability of patients with type 2 DM， keep BG in stable control， and reduce or delay the occurrence of diabetic complications.

[Key words] Diabetes mellitus; Type 2; Continuous nursing; Blood glucose fluctuation; Self-management

据统计我国成人糖尿病患病率高达11.6%[1]，其中2型糖尿病（Type 2 diabetes mellitus，T2DM）占90%。T2DM主要特点是高血糖和血糖波动幅度大，早期不积极干预会导致各种慢性并发症的发生。目前我国T2DM患者自我管理水平差[2]，血糖控制率低，并发症发生率高[3，4]，因此持续的医疗支持和患者自我管理知识、技能的发展至关重要[5]。在延续性护理模式下，医护人员对患者的诊疗不会随着出院而结束，而是从医院到家庭提供进一步的医疗/护理支持[6，7]。本研究在早期T2DM患者中应用延续性护理，探讨其对患者自我管理能力、血糖水平和血糖波动的影响，现报道如下。

1 资料与方法

1.1 一般资料

采用方便抽样法于2018年1月～2019年9月选取山西省汾阳医院内分泌科T2DM住院患者100例，随机分为观察组与对照组，各50例。……