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【摘要】目的 探讨整体护理在硫辛酸联合前列地尔治疗糖尿病肾病(DN)过程中的应用效果。方法 选取2014年9月至2017年12月到哈尔滨医科大学附属第一医院就诊的86例DN患者作为研究对象,按照采取的不同护理方法分为对照组(40例)与观察组(46例)。2组均给予硫辛酸结合前列地尔治疗,以14 d为1个疗程,治疗3个疗程。对照组给予传统护理;观察组在对照组护理的基础上给予整体护理。比较2组总有效率、治疗前后24 h尿蛋白定量、护理前后自我护理能力评分和治疗期间不良反应发生率。结果 治疗后,观察组总有效率明显高于对照组[97.8%(45/46)比82.5%(33/40)],差异有统计学意义(P=0.015)。治疗前,2组24 h尿蛋白定量比较,差异无统计学意义(P=0.672)。治疗后,2组24 h尿蛋白定量均明显低于治疗前,且观察组明显低于对照组[(381±78)mg/24 h比(523±80)mg/24 h],差异均有统计学意义(均P<0.05)。护理前,2组自我护理能力评分比较,差异无统计学意义(P=0.622)。治疗后,2组自我护理能力评分均明显高于治疗前,且观察组明显高于对照组[(21.5±3.8)分比(18.4±2.5)分],差异均有统计学意义(均P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组[4.3%(2/46)比27.5%(11/40)],差异有统计学意义(P=0.003)。结论 整体护理在硫辛酸联合前列地尔治疗DN过程中的应用能改善肾功能,提高治疗效果与患者的自我护理能力,减少不良反应的发生,应用效果较好。
【Abstract】Objective To explore the application effect of holistic nursing on diabetic nephropathy(DN) patients treated with lipoic acid and alprostadil. Methods Eighty-six patients with DN who visited the First Affiliated Hospital of Harbin Medical University from September 2014 to December 2017 were divided into control group(40 cases) and observation group(46 cases). Both groups were treated with lipoic acid and alprostadil for 3 courses, with 14 days as a course of treatment. The control group had traditional nursing and the observation group had holistic nursing care. Total effective rate, 24 h urinary protein content, self-care ability score and adverse reactions were analyzed. Results Total effective rate in the observation group was significantly higher than that in the control group[97.8%(45/46) vs 82.5% (33/40)](P=0.015). There was no statistical difference of 24 h urinary protein content between groups before treatment(P=0.672). After treatment, 24 h urinary protein content significantly decreased in both groups and it was lower in the observation group than that in the control group[(381±78)mg/24 h vs (523±80)mg/24 h](P<0.05). There was no statistical difference of self-care ability score between groups before treatment(P=0.622); the score significantly increased after treatment in both groups and it was higher in the observation group than that in the control group[(21.5±3.8) vs (18.4±2.5)](P<0.05). Incidence of adverse reactions in the observation group was significantly lower than that in the control group[4.3%(2/46) vs 27.5%(11/40)](P=0.003). Conclusion Application of holistic nursing in DN patients treated with lipoic acid and alprostadil can promote renal function recovery, improve the therapeutic effect and self-care ability and reduce adverse reactions.
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