护理风险管理能有效提高糖尿病合并恶性肿瘤患者的化疗疗效.docVIP

护理风险管理能有效提高糖尿病合并恶性肿瘤患者的化疗疗效 徐灵莉，邓本敏，唐 玲，刘 玲，李真华（400030重庆，重庆市肿瘤研究所） [摘要]目的 在糖尿病合并恶性肿瘤化疗患者中，评价护理风险管理干预对临床治疗效果及护理质量的影响。方法 筛选2010年2月至2011年1月收治糖尿病合并恶性肿瘤化疗患者87例（对照组）；2011年2月至2012年2月收治糖尿病合并恶性肿瘤化疗患者109例，实施护理风险管理（观察组）。对照组按常规实施方法进行护理风险管理，主要包括：糖尿病知识宣教及对症处理；观察组采用PDCA[（计划Plan执行Do检查Check处理Action）]循环式风险管理策略，个体化处置式风险控制方法、化疗全流程式风险预防措施，进行化疗期间的护理风险管理。对比观察两组糖尿病急性并发症发生情况、化疗药物外渗的发生情况、患者满意度，探讨实施护理风险管理的临床价值。结果 实施护理风险管理后，糖尿病合并恶性肿瘤化疗患者的低血糖（1.83%vs9.19%）、高渗性痛症酸中毒（0.91% vs6.89%）、非酮症酸中毒（0.91% vs 5.74%）发生率，化疗药物外渗情况（0 vs3.45%）及患者满意度（98.16% vs91.96%）均优于对照组（P0.05）。结论 护理风险管理能有效提高糖尿病合并恶性肿瘤患者的化疗效果、较好控制血糖，避免并发症的发生。 [关键词]恶性肿瘤；糖尿病；化疗；风险管理 Risk management of nursing in the chemotherapy for patients with malignant tumor and comorbidity of diabetes mellitus Xu Lingli，Deng Benmin，Tang Ling，Liu Ling，Li Zhenhua（Chongqing Cancer Insitute, Chongqing，400030，China） [Abstract] Objective To evaluate the impact of nursing risk management on the clinical therapeutic effect and nursing quality in patients undergoing chemotherapy with malignant tumor and DM. Methods In control group, eighty-seven patients from 2010.2 to 2011.1 were recruited and received routine nursing risk management including education of diabetes knowledge and treatment; in test group, one hundred and nine patients recruited from 2011.2 to 2012.2 were included and under the the risk management of nursing, who received PDCA （Plan Do Check Action）cycling risk management, including individualized risk control method, risk prevention progrom of chemotherapy, and nursing risk management during chemotherapy. The incidences of acute complications of diabetes or extravasation of chemotherapeutic drugs and patients satisfaction were recorded. Results The incidence of acute complications of diabetes or of extravasation of chemotherapeutic drugs were significantly decreased and patients satisfaction was increased after implementation of nursing risk management. Conclusion Nursing risk management in patients undergoing chemotherapy with malignant tu