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合并糖尿病的阻塞性睡眠呼吸暂停低通气综合征患者的围手术期护理

Research in perioperative nursing methods in patients with OSAHS and type 2 diabetes mellitus

摘要:

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病患者的围手术期护理方法.方法 将2009年3月至2010年12月收治的46例OSAHS合并2型糖尿病围手术期患者随机分为对照组和实验组各23例,对照组施以常规护理,实验组在常规护理措施基础上采用针对合并糖尿病的OSAHS患者的分阶段、个体化、规范化全面的护理措施.评估患者术前、术后睡眠情况,观察2组患者术后口咽部切口愈合、并发症及疼痛等情况.结果 对照组术中出血1例、术后出血1例及术后感染2例,3例术后出现高血糖,2例出现低血糖.实验组患者无一例出现合并症.2组患者术前1d的睡眠质量(PSQI)评分明显高于入院时,出院时的评分明显低于入院时.实验组较对照组PSQI评分改善更显著.2组患者手术当天疼痛评分最高,后逐日降低,实验组均明显低于对照组.结论 合并糖尿病的OSAHS患者围手术期接受全面的护理,不仅可以降低此类疾病手术的风险,减少术中、术后出血及术后感染等并发症,而且能提高其手术疗效、护理质量和患者的生活质量,促进患者早日康复.

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abstracts:

Objective To study the perioperative nursing methods in patients with OSAHS and type 2 diabetes mellitus.Methods From March 2009 to December 2010,a total of 46 patients with OSAHS and type 2 diabetes mellitus were randomly divided into the control group and the experimental group with 23 cases in each group.Conventional care was given to the control group,while the experimental group received systematic,phased and individualized nursing.The sleep quality before and after the operation was compared.The oropharynx wound healing and possible complications,pain were observed after operation.Results In the control group,there was one patient with bleeding during operation,one patient happened blood lost after operation and 2 patients had postoperative infection.The hyperglycemia was found in 3 patients and hypoglycemia occurred in 2 patients.But in the experimental group,all of the patients did not suffer complication.The scores of sleep quality on the day before surgery were significantly higher than those scores on admission,and the scores on discharge from hospital were significantly lower than those scores on admission.There were statistical differences.The scores of the experimental group were significantly improved compared to those of the control group.The score of pain was the highest at the day of surgery,and then gradually decreased.The score of pain of the experimental group was significantly lower than that of the control group,and the difference was statistically significant.Conclusions This comprehensive nursing method during operation period for patients with OSAHS and type 2 diabetes mellitus not only can reduce risk of postoperative complication,but also can improve operation efficacy,quality of nursing and life quality of patients as well as can speed recovery.It approved that this standardized,systematic nursing method during the whole period is practical and effective in OSAHS and type 2 diabetes mellitus treatment and care.

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