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目的探讨糖尿病足患者的临床特点及循证护理的疗效。方法收集2000年5月—2012年5月在北京朝阳医院京西院区住院的患者246例,随机分为循证护理组(122例)和一般护理组(124例)。循证护理组采用循证护理方案,一般护理组采用基础护理方案。收集患者糖尿病足发生的诱因、血糖、血压、血脂、糖化血红蛋白(HbA1c)、住院天数、预后等资料,并在患者出院3个月后进行电话随访评价每日坚持足部护理的依从性。结果糖尿病足通常发生在老年、糖尿病病程长、血糖及血压控制差的患者中,61.4%(151/246)的患者有明确的诱因,发生率随年龄增加而升高(χ2=30.42,P<0.01)。循证护理组较普通护理组血糖、血压、血脂控制好(P<0.01或P<0.05),住院时间短(P<0.01),总的治疗有效率(P<0.01)高,出院后患者每日坚持足部护理的依从性高(χ2=8.739,P<0.01)。结论循证护理能有效防治糖尿病足,提高患者长期足部护理的依从性,预防足溃疡的复发,降低糖尿病足患者的截肢风险。
Objective To investigate the clinical features of diabetic foot patients and the efficacy of evidence-based nursing. Methods A total of 246 patients hospitalized in Beijing West Hospital of Beijing Chaoyang Hospital from May 2000 to May 2012 were randomly divided into evidence-based nursing group (122 cases) and general nursing group (124 cases). Evidence-based care group using evidence-based care programs, general care group using basic care programs. Blood glucose, blood pressure, blood lipid, HbA1c, days of hospitalization, and prognosis were collected from patients with diabetes mellitus. Telephone follow-up was performed 3 months after discharge to assess the adherence of daily foot care. Results Diabetic foot usually occurred in elderly patients with long duration of diabetes and poor control of blood glucose and blood pressure. Among them, 61.4% (151/246) patients had definite inducement, the incidence increased with age (χ2 = 30.42, P < 0.01). The evidence-based nursing group had better control of blood glucose, blood pressure and blood lipids (P <0.01 or P <0.05), shorter hospital stay (P <0.01) and higher total effective rate (P <0.01) Day adhere to foot care compliance (χ2 = 8.739, P <0.01). Conclusion Evidence-based nursing can effectively prevent and treat diabetic foot, improve compliance of long-term foot care, prevent the recurrence of foot ulcer and reduce the risk of amputation in patients with diabetic foot.