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糖尿病足溃疡的综合护理模式:改善预后和生活质量的策略。

Comprehensive nursing model for diabetic foot ulcers: A strategy to improve prognosis and quality of life.

机构信息

Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Medicine (Baltimore). 2024 Jun 28;103(26):e38674. doi: 10.1097/MD.0000000000038674.

Abstract

Diabetic foot (DF) ulcer is one of the common complications of diabetic patients, with high incidence and amputation rate, which seriously affects the quality of life and health of patients. Therefore, how to effectively prevent and treat DF ulcers and reduce amputation rate has become an urgent problem in the medical field. As a comprehensive nursing model for patients with DF ulcers, comprehensive nursing intervention is designed to improve the therapeutic effect and prognosis and reduce the rate of amputation. Convenient sampling method was used to select 360 patients with DF who received routine care for DF ulcers from July 2013 to July 2023 for retrospective cohort analysis. According to the existence of exposure factors (comprehensive nursing intervention), 180 cases were divided into observation group and comparison group. The basic demographic data, amputation rate, severity of foot ulcer, neuropathy and vascular disease, and blood glucose control were compared between the 2 groups. The data was analyzed using SPSS26.0. Harman single factor test was used to check whether there was common method bias in the study data. Descriptive analysis, Spearman rank correlation analysis and multiple linear regression analysis were used to analyze the current situation of amputation rate of DF patients and the influence of comprehensive nursing intervention on the amputation rate of DF patients. The amputation rate was 2.8% in the Observation group compared to 8.3% in the Comparison group. The amputation rate of the observation group was generally higher in the age group, and the amputation rate of the observation group was higher in the middle school education level and below and the economic status of <5000 yuan. The difference was statistically significant (P < .05). Age (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 0.88-4.38), education level (OR = 1.30; 95% CI: 1.69-6.46), economic status (OR = 2.28; 95% CI: 1.69-10.85) was an independent risk factor for amputation rate (P < .05). Comprehensive nursing interventions have played a positive role in reducing the rate of amputation in patients with DF.

摘要

糖尿病足(DF)溃疡是糖尿病患者常见的并发症之一,具有高发病率和截肢率,严重影响患者的生活质量和健康。因此,如何有效预防和治疗 DF 溃疡,降低截肢率,已成为医学界亟待解决的问题。综合性护理干预是一种针对 DF 溃疡患者的综合护理模式,旨在提高治疗效果和预后,降低截肢率。采用便利抽样法,回顾性分析 2013 年 7 月至 2023 年 7 月间收治的 360 例接受常规 DF 溃疡护理的 DF 患者。根据是否存在暴露因素(综合性护理干预),将 180 例患者分为观察组和对照组。比较两组患者的基本人口统计学数据、截肢率、足部溃疡严重程度、神经病变和血管疾病以及血糖控制情况。采用 SPSS26.0 软件进行数据统计分析。采用单因素 Harman 检验判断研究数据是否存在共同方法偏差。采用描述性分析、Spearman 秩相关分析和多元线性回归分析,分析 DF 患者截肢率现状及综合性护理干预对 DF 患者截肢率的影响。观察组截肢率为 2.8%,对照组为 8.3%。观察组截肢率在年龄组中普遍较高,观察组在中学及以下教育程度和经济状况<5000 元的患者中截肢率较高,差异有统计学意义(P<0.05)。年龄(比值比[OR]=1.96;95%置信区间[CI]:0.88-4.38)、教育程度(OR=1.30;95%CI:1.69-6.46)、经济状况(OR=2.28;95%CI:1.69-10.85)是截肢率的独立危险因素(P<0.05)。综合性护理干预对降低 DF 患者截肢率发挥了积极作用。

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