[1]黄剑波.临床路径在糖尿病患者术前麻醉准备中的应用效果研究[J].中国卫生质量管理,2016,23(05):046-48.[doi:10.13912/j.cnki.chqm.2016.23.5.14]
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临床路径在糖尿病患者术前麻醉准备中的应用效果研究
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第23卷
期数:
2016年05期
页码:
046-48
栏目:
临床路径
出版日期:
2016-09-28

文章信息/Info

作者:
黄剑波
儋州市第一人民院
关键词:
临床路径糖尿病手术麻醉应用效果
Keywords:
Clinical Pathway Diabetes Anesthesia Application Effect
DOI:
10.13912/j.cnki.chqm.2016.23.5.14
摘要:
目的研究临床路径在糖尿病手术患者术前麻醉准备中的应用效果。方法选取2014年6月-2015年6月间入院诊治的糖尿病患者76例,随机将患者分为治疗组(38例)与对照组(38例)。两组患者均应用硬膜外麻醉。对照组行常规术前麻醉准备;治疗组则按临床路径进行麻醉前准备。观察并记录两组患者术前1d(T1,等待手术时)及入手术室时(T2,麻醉医生准备实施麻醉前10min)血糖、尿酮以及患者的应激状态(血压、心率及SAS焦虑评分)的变化。结果两组患者T1与T2的尿酮均无显著差异;两组患者T1血糖并无显著差异,治疗组T2血糖较对照组较好地维持了血糖稳定(P<0.05)。两组患者在T1时段心率、收缩压与SAS评分无显著差异;治疗组T2时段心率、收缩压与SAS评分与T1相比无显著差异,而对照组差异显著(P<0.05)。结论临床路径在糖尿病手术患者术前麻醉中具有较好的应用效果,对血糖的影响较小,同时可有效缓解患者术前的焦虑,改善血压与心率应激状态。
Abstract:
ObjectiveTo investigate the effect of on preoperative anesthesia preparation among diabetic patients to provide reference for clinical surgical treatment.MethodBetween June 2014 and June 2015, 76 preoperative diabetic inpatients needing epidural anesthesia were included and randomly divided into treatment group (38 cases) and control group (38 cases). The control group underwent routine preoperative anesthesia preparation, and the treatment group underwent clinical pathway on preoperative anesthesia preparation. Changes of blood glucose, ketone and stringent state (blood pressure, heart rate and SAS scores of anxiety) at one day before operation (T1, waiting for operation) and at the time entering the operation room (T2, 10 mins before anesthesia) of the two groups were recorded. ResultAt T1 and T2, no statistical significance was found between the two groups on urine ketone, and at T1, no statistical significance was found between the two groups on blood glucose. However, at T2, the treatment group had better blood glucose levels than the control group (6.26±1.57 vs. 8.12±0.35 mmol/L, P<0.05). There was no significant difference on heart rate, systolic blood pressure and SAS score between the two groups at T1. Compared with T1, the heart rate, systolic blood pressure and SAS score of the treatment group had no significant difference, but those of the control group had significant difference (P<0.05). ConclusionThe clinical pathway has good clinical effect on preoperative anesthesia among diabetic patients undergoing surgical anesthesia, which had less impact on blood glucose, and can effectively alleviate the preoperative anxiety in patients, improve blood pressure and heart rate stress.

参考文献/References:

[1]路阳,李中凯,陆晨,等.县级医院推行临床路径管理障碍分析和对策研究[J].中国卫生质量管理,2016,23(1):22-26.

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更新日期/Last Update: 2016-09-28