糖尿病腹膜透析病人足部评估及护理现状调查.docVIP

糖尿病腹膜透析病人足部评估及护理现状调查 ? 114?中华护理杂志2008年2月第43卷第2期 糖尿病腹膜透析病人足部评估及护理现状调查 马艳秋苏春燕唐雯张枫聂建东孙玲华汪涛 【摘要】目的了解糖尿病肾病行腹膜透析病人足部病变的状况,所接受到的足部护理教育和指导,以及足部自我护理的情 况.方法采用英国足部筛查实验对46例糖尿病肾病腹透病人的足部神经病变进行症状和体检评分;应用触摸动脉搏动和测 量踝一臂指数(ABI)来判断病人的足部血管病变状况;同时应用问卷调查病人的足部护理行为能力和曾接受过的足部护理教育 和指导.结果73.9%的病人存在足部周围神经病变,41.3%的病人动脉搏动异常,同时存在以上两种情况的病人占37%;ABI 的测定表明,54.3%的病人存在不同程度的血管病变.76.1%的病人在过去1年中未接受过糖尿病教育,91-3%的病人从未接受 过糖尿病足的评估,84.8%的病人从未接受过足部护理指导.他们的足部自我护理行为,尤其是每日足部检查和鞋子检查的得 分较低.结论糖尿病肾病行腹透的病人足部病变状况比较严重,但足部自我护理行为较差,所接受的教育和指导不够,需要 引起医护人员的重视. 【关键词】糖尿病肾病;腹膜透析;糖尿病足;自我护理 Investigateoffootconditionsandfootcarestatusofperitonealdialysispatientswithdiabeticnephropathy/MAYah- qiu,SUChun-yan,TANGWen,ZHANGFeng,NIEJian-d0ng,SUNLing-hua,WANGTao//ChineseJournalofNurs- ing,一2008,43(2):114. [Abstract】ObjectiveToinvestigatethefootcondition,selfcareactivitiesandacquirededucationonfootcareofperi- tonealdialysispatientswithdiabeticnephropathy.MethodsForty—sixdiabeticpatientsundergoingperitonealdialysiswereen— roUedinthisstudy.111eUnitedKingdomfootscreeningtest,palpationofpulseonlowerlimbsarteries,andankle—brachial index(ABI)weleusedtoevaluatetheneuropathyandvasculopathyconditionofpatients’feet.111eselfcareactivitiesandac- quirededucationonfootcarewereevaluatedbyanselfreposedquestionnaire.Results73.9%patientshadneuropathy. 41_3%patientshada~erialpulseabnormality.meanwhile37%ofthemhadboth.76.1%patientshadneveraccepteddiabetic educationprogram.91.3%and84.8%ofthemhadneveracceptedfootconditionevaluationordirectionbymedicalstaff.Their selfcareactivities.especiallydailyinspectiononfootandshoeswereunderoptimized.ConclusionThefootproblemswere severeindiabeticpatients’undergoingperitonealdialysis.Theselfcareactivityoffootcarewaspoor.andtheyneedmole instructions. 【Keywords】DiabeticNephropathies;PeritonealDialysis;DiabeticFoot;SelfCare 【Author’saddress】DepartmentofNephrology,TheThirdHospitalofPekingUniversity,Beijing,100083,China 作者单位:100083北京大学第三医院肾内科 马艳秋:女,大专,护士,E—mall:karenma813@163.com 本课题受教育部长江学者奖励计划和教育振兴行动计划专项基金 资助,编号:9853-程-36—1;院临床