目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期进行管理,以抢救生命、治疗疾病为重点,期间以控制管理基础疾病为基础,包括预防感染、血糖管理、症状护理、血浆置换护理、管道管理、心理护理等方面。结果:连续治疗10 d后患者生命体征暂时能够平稳,病情得到控制。结论:对患者生命治疗周期进行整体管控护理,针对基础慢性疾病合并疑难急症进行科学合理地护理,能迅速保障患者生命安全、提升治疗效率。Objective: To summarize the key points of nursing for a 64-year-old patient with type II diabetes mellitus complicated with thrombotic thrombocytopenic purpura during inpatient treatment for major nursing problems such as infection, endocrine and metabolic disorders, bleeding and gas exchange disorders during plasma exchange treatment, in order to provide reference for similar cases. Methods: The whole cycle of treatment was managed, focusing on life-saving and disease treatment, and the control and management of underlying diseases were the basis, including infection prevention, blood glucose management, symptom nursing, plasmapheresis nursing, pipeline management, and psychological nursing. Results: After 10 days of continuous treatment, the patient’s vital signs were temporarily stable and the condition was controlled. Conclusion: The overall control and nursing of the patient’s life cycle and the scientific and reasonable nursing for the underlying chronic diseases combined with intractable and urgent diseases can quickly ensure the life safety of patients and improve the treatment efficiency.
背景:近年来随着人们生活方式的改变,我国糖尿病(Diabetes Mellitus type 2, T2DM)患病人数快速增加。动脉粥样硬化性心血管疾病(Atherosclerotic Cardiovascular Disease, ASCVD)是T2DM患者死亡的主要原因,该疾病对我国人民健康造成严重威胁。目的:调查并探讨深圳市福田区居民ASCVD风险级别的影响因素,分析社康中心综合干预策略效果。方法:通过EPM (Electronic Patient Management, EPM)家庭医生签约信息平台收集2023年度在深圳市福田区4家社康中心签约就诊的患者个人信息及体检数据并对干预效果进行对比,分析相关影响因素。结果:共回收有效数据1011份,有效回收率为98.06%。ASCVD终生风险低风险组占19.29% (195/1011);ASCVD终生风险高风险组80.71% (816/1011)。二元Logistic回归分析结果显示,年龄、男性、BMI、LDLC、HDLC是风险级别从低风险到高风险转变的重要因素,同时提示干预措施并未显著降低风险级别可能性,干预组社康的干预策略仍然需要进一步调整。结论:深圳市福田区II型糖尿病患者中,有心血管疾病家族史的男性患者处于ASCVD的高风险机率更高,因此这类患者要加强用药管理与饮食管理,家庭医生也应以家庭为单位指导居民健康的膳食模式,同时注重配合患者搭建自我用药管理方案,避免漏服拒服的情况发生。家庭医生需针对个体的ASCVD影响因素来设定疾病防控目标才能获得群体更显著的干预效果。Background: In recent years, with the change in people’s lifestyles, the number of patients with diabetes mellitus type 2 (T2DM) in our country has increased rapidly. Atherosclerotic Cardiovascular Disease (ASCVD) is the main cause of death for T2DM patients and poses a serious threat to the health of our people. Objective: To investigate and explore the influencing factors of Atherosclerotic Cardiovascular Disease (ASCVD) risk levels among residents in Futian District, Shenzhen, and to analyze the
