专科护士开展糖尿病足危险因素筛查与护理指导的效果及意义

目的探讨以糖尿病专科护士为主导的糖尿病足危险因素筛查与护理指导的效果。方法2006年1月-2007年4月由2名糖尿病专科护士对143例2型糖尿病患者进行糖尿病足危险因素筛查，发现115例患者存在多个糖尿病足危险因素，28例患者存在单个糖尿病足危险因素。危险因素包括：糖尿病知识缺乏，视力严重下降，吸烟，震动感觉减弱或消失，保护性感觉缺失，温觉减退，足部皮肤干燥、皲裂，有赤脚走路习惯等。根据筛查的结果，针对患者存在的糖尿病足危险因素，进行个体化、针对性的健康教育和足部护理指导。结果120例患者坚持每天检查足部，10例不能观察自己足的患者，均能定时请家人检查足部，10例有赤脚走路习惯的患者均改正其不良行为，40例吸烟患者中20例已戒烟，其余已减少吸烟量，37例肥胖患者均不同程度减轻了体质量，其中有8例体质量基本达标。随访6～12个月，均无发生足部新的损伤。全部患者掌握糖尿病足部护理知识，提高了遵医行为。结论糖尿病专科护士对糖尿病知识掌握全面，能够全面评估患者的个体情况及存在的问题，有针对性地设计并实施个体化的教育计划，提高患者的自我防护意识，有效地控制患者糖尿病足溃疡的发生。

Effect of Risk Factors Shifting of Diabetic Foot by Specialized Nurses and Nursing Guidance

Objective To explore effect of risk factors shifting of diabetic foot by specialized nurses and nursing guidance. Methods From Jan. 2006 to Apr. 2007, risk factors of diabetic foot in 143 patients with Type Ⅱ diabetes were shifted by 2 specialized nurses. Multiple risk factors of diabetic foot were found in 115 patients and single risk factor was found in 28 patients. The risk factors included： deficiency of diabetes knowledge, smoking, weakening and disappearance of vibrating feel, weakening of protective feel and temperature feel, dryness and chaps of skin, poor eyesight and habit of walking with bare feet. According to the result of shifting, personalized and pertinent health education and foot nursing guidance were made. Results 120 patients persisted in examining feet every day, 10 who could not examine themselves were examined by families, 10 with the habit of walking with bare feet changed their habits, 20 of 40 who smoked gave up smoking, 37 over weighted patients reduced their weight and 8 had the standard weight. After follow-ups of 6-12 months, no new foot injury was found. All patients grasped the knowledge on nursing and their compliance were improved. Conclusion Specialized nurses of diabetes have a complete knowledge on diabetes, can evaluate the situation and found the existing problems, can design and perform personalized health education, improve their consciousness of self protection and control the occurrence of diabetic foot ulcer effectively.