老年重癥監護室糖尿病患者血糖難控制的原因及護理策略研究

[摘要] 目的 以ICU內老年糖尿病患者為研究對象，對其血糖難控制的因素與護理策略進行探究。方法 按照隨機抽取的方式，將2018年1月—2019年2月前往該院ICU治療的70例老年糖尿病患者劃分為兩個小組，每組均為35例，并對兩組患者的基本狀況以及觀察組患者血糖難控制的原因進行分析，然后對觀察組患者采取護理干預策略。結果 造成老年ICU糖尿病患者血糖居高不下的因素是多方面的，如代謝紊亂、年齡較高、存在創傷性疾病、APACHEⅡ評分不理想等，但經過實施護理干預措施以后，觀察組患者的血糖濃度、糖化血紅蛋白（HbA1c）與護理前相比得到了顯著改變（P<0.05），同時還產生了遠高于對照組的護理滿意度（P<0.05）。結論 針對老年ICU糖尿病患者血糖難控制的主因采取適宜的護理干預措施，能夠使老年重癥監護室糖尿病患者的血糖水平得到有效控制，有助于獲得良好的護理滿意度。

[關鍵詞] ICU;老年糖尿病患者;血糖控制;護理干預策略

[中圖分類號] R47? ? ? ? ?[文獻標識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）02（a）-0172-03

Study on the Causes of Difficult Blood Glucose Control and Nursing Strategies for Diabetic Patients in Elderly Intensive Care Unit

XIONG Ju-hua

Department of Critical Care Medicine， Quanzhou First Hospital， Quanzhou， Fujian Province， 362000 China

[Abstract] Objective To investigate the factors and nursing strategies of difficult control of blood glucose in elderly patients with diabetes in the ICU. Methods According to a random sampling method， 70 elderly diabetic patients who were treated in the ICU of the hospital from January 2018 to February 2019 were divided into two groups， each group was 35， and the basic conditions of the two groups of patients， the reasons for the difficulty of blood glucose control in the observation group were analyzed， and then nursing intervention strategies were adopted in the observation group. Results There are many factors that cause high blood glucose in elderly ICU diabetic patients， such as metabolic disorders， higher age， traumatic diseases， poor APACHEⅡ score， etc.， but after the implementation of nursing interventions， the observation group of patients of the blood glucose concentration and glycated hemoglobin （HbA1c） were significantly changed compared with before nursing（P<0.05）， and at the same time， the nursing satisfaction was much higher than that of the control group（P<0.05）. Conclusion Taking appropriate nursing interventions for the main causes of difficult blood glucose control in elderly ICU diabetic patients can effectively control the blood glucose levels of diabetic patients in elderly intensive care units and help to obtain good nursing satisfaction.

[Key words] ICU; Elderly diabetic patients; Blood glucose control; Nursing intervention strategies

與一般糖尿病患者相比，老年ICU糖尿病患者無論是年齡還是體質均處于弱勢，而且大多在入院時就具有高血糖以及多種并發癥，因此老年ICU糖尿病患者的血糖很難在短期內產生良好的控制效果[1]。由于老年ICU糖尿病患者通常病情嚴重，其生命安全很容易受到威脅，因而應當對導致其血糖控制難度較大的因素進行分析并采取針對性的措施[2]。基于此，該文以該院2018年1月—2019年2月收治的70例上述患者為研究對象，將其劃分為兩組，對35例觀察組患者血糖難以控制的因素進行了分析，并實施了針對性的護理干預措施，最終使其血糖水平得到了顯著改善，產生了理想的護理滿意度。現將該次研究過程報道如下。

1? 資料與方法

1.1? 一般資料