老年糖尿病夜间低血糖的预防及护理

老年糖尿病夜间低血糖的预防及护理

摘要

低血糖为糖尿患者出现的伤害最大的症状中的一类,也是死亡的原因之一,糖尿病往往发生在晚上,由于年龄较大病人身体情况弱化，极易出现低血糖，在临床上有可能产生头晕、心悸、出汗、饥饿，严重的甚至出现昏迷，倘若没有被及时的发现，症状持续很长时间，病人的神经系统将会受到伤害，有可能会导致死亡；老年糖尿病夜间低血糖相关研究在国外是非常热门的，许多前瞻性的相关论证结果已经完成。

目的：根据临床上老年糖尿病病人夜间出现低血糖的各种病状，研究如何预防和护理。方法：对于2016年1~12月入住该院内分泌科的218例老年糖尿病患者，进行住院病历与床边调查的会诊，收集患者资料，在护理实践中进行数据的收集、处理，并进行数据分析，其主要包括患者病情、治疗及服药依从性、夜间低血糖发生次数、胰岛素使用情况、血糖及糖化血红蛋白波动指标、饮食习惯及排泄情况等。结果：在夜间，实验组和对照组的低血糖发生率为16.67%（5例）和66.67%（20例），前者比后者低得多，差异在统计学上意义显著（P<0.05）。经统计和调查发现，老年糖尿病患者夜间低血糖发生主要因素与治疗用药依从性、饮食及活动情况、心理状况、并发症因素等呈正相关。结论：在临床中对老年糖尿病夜间低血糖症多注意观察和加强护理为让病人和家属认真意识到其严重性和危害性的最重要的因素。加强对夜间低血糖的有效控制并采取及时有效的护理干预，可全面提升护理效果，提高患者生存质量。

关键词：夜间低血糖；老年糖尿病；预防；护理

Prevention and Nursing of Nocturnal Hypoglycemia in

Senile Diabetes

Abstract

Diabetes low blood sugar is one of the most serious complications of diabetes treatment, and is also one of the reasons for death, diabetes tend to occur at night, because the elderly physiological hypofunction, prone to low blood glucose reaction in the process of treatment.The patient may experience dizziness, palpitation, perspiration, pale and hunger. and even coma, if not timely found that sustained severe hypoglycemia is not correct in time, will result in patients with nervous system damage, even life threatening. The study on the nocturnal hypoglycemia of elderly diabetes is very popular in foreign countries, and a lot of prospective studies have been carried out.

Objective:To analyze the hypoglycemia at night in elderly patients with diabetes mellitus, and to study the related measures and nursing plans for preventing hypoglycemia at night.Method:For 1 ~ 12, 2016 in the hospital endocrinology, 218 cases of elderly diabetes patients in hospital medical records and bedside investigation of consultation, and patient information collection, in the nursing practice for data collection, processing, and data analysis, it mainly includes the illness, treatment and medication adherence, nocturnal hypoglycemia occurrences, blood glucose, and glycosylated hemoglobin, insulin use volatility index, diet habit and excretion.Result:At night, the incidence of hypoglycemia in the experimental group and the control group was 16.67%(5 cases) and 66.67%(20 cases) respectively, the former was far lower than the latter, and the difference was statistically significant (P<0.05). According to the statistics and investigation, the main factors of nocturnal hypoglycemia in elderly diabetics were positively correlated with the treatment of medication compliance, diet and activity, psychological status and complications.Conclusion:Elderly diabetes clinical observation and nursing of nocturnal hypoglycemia, the most important thing is to make the patients and their families to recognize the severity and harmfulness of fully, to strengthen the effective control of nocturnal hypoglycaemia and take timely and effective nursing intervention, can improve the nursing effect, improve the quality of survival.

Key word：Nocturnal hypoglycemia; geriatric diabetes; prevention; nursing