老年糖尿病夜间低血糖的预防及护理

老年糖尿病夜间低血糖的预防及护理(论文13000字)
摘要
糖尿病低血糖是糖尿病治疗最严重的并发症之一,也是死亡的原因之一,糖尿病往往发生在晚上,因为老年人生理机能减退,容易发生低血糖反应在治疗病人的过程中可能会出现头晕心悸汗水苍白强烈的饥饿甚至昏迷,如果没有及时发现,持续严重的低血糖是不正确的时间,将导致患者神经系统损害,甚至危及生命；老年糖尿病夜间低血糖相关研究在国外是非常热门的，许多前瞻性研究已经完成。
目的：分析老年糖尿病患者夜间低血糖的情况，并研究预防夜间低血糖的相关措施和护理方案。方法：对于2016年1~12月入住该院内分泌科的218例老年糖尿病患者，进行住院病历与床边调查的会诊，收集患者资料，在护理实践中进行数据的收集、处理，并进行数据分析，其主要包括患者病情、治疗及服药依从性、夜间低血糖发生次数、胰岛素使用情况、血糖及糖化血红蛋白波动指标、饮食习惯及排泄情况等。结果：在夜间，实验组和对照组的低血糖发生率为16.67%（5例）和66.67%（20例），前者比后者低得多，差异在统计学上意义显著（P<0.05）。经统计和调查发现，老年糖尿病患者夜间低血糖发生主要因素与治疗用药依从性、饮食及活动情况、心理状况、并发症因素等呈正相关。结论：老年糖尿病夜间低血糖症的临床观察和护理是使患者及其家属充分认识到其严重性和危害性的最重要的因素。加强对夜间低血糖的有效控制并采取及时有效的护理干预，可全面提升护理效果，提高患者生存质量。

关键词：夜间低血糖；老年糖尿病；预防；护理
 
Prevention and Nursing of Nocturnal Hypoglycemia in Senile Diabetes
Abstract
Diabetes low blood sugar is one of the most serious complications of diabetes treatment, and is also one of the reasons for death, diabetes tend to occur at night, because the elderly physiological hypofunction, prone to low blood glucose reaction in the process of treatment.The patient may experience dizziness, palpitation, perspiration, pale and hunger. and even coma, if not timely found that sustained severe hypoglycemia is not correct in time, will result in patients with nervous system damage, even life threatening. The study on the nocturnal hypoglycemia of elderly diabetes is very popular in foreign countries, and a lot of prospective studies have been carried out.
Objective:To analyze the hypoglycemia at night in elderly patients with diabetes mellitus, and to study the related measures and nursing plans for preventing hypoglycemia at night.Method:For 1 ~ 12, 2016 in the hospital endocrinology, 218 cases of elderly diabetes patients in hospital medical records and bedside investigation of consultation, and patient information collection, in the nursing practice for data collection, processing, and data analysis, it mainly includes the illness, treatment and medication adherence, nocturnal hypoglycemia occurrences, blood glucose, and glycosylated hemoglobin, insulin use volatility index, diet habit and excretion.Result:At night, the incidence of hypoglycemia in the experimental group and the control group was 16.67%(5 cases) and 66.67%(20 cases) respectively, the former was far lower than the latter, and the difference was statistically significant (P<0.05). According to the statistics and investigation, the main factors of nocturnal hypoglycemia in elderly diabetics were positively correlated with the treatment of medication compliance, diet and activity, psychological status and complications.Conclusion:Elderly diabetes clinical observation and nursing of nocturnal hypoglycemia, the most important thing is to make the patients and their families to recognize the severity and harmfulness of fully, to strengthen the effective control of nocturnal hypoglycaemia and take timely and effective nursing intervention, can improve the nursing effect, improve the quality of survival.

Key word：Nocturnal hypoglycemia; geriatric diabetes; prevention; nursing

目  录
摘要    I
Abstract    II
1 绪论    1
1.1 研究背景    1
1.2 研究目的    2
1.3 研究意义    2
1.4老年糖尿病夜间低血糖的发生原因    3
1.4.1 自身机体因素    3
1.4.2胰岛素剂量过量    3
1.4.3 情绪因素    3
1.4.4 知识缺乏    3
1.4.5 运动量过大    3
2 资料与方法    3
2.1 研究对象    3
2.2 护理方法    4
2.2.1 对照组    4
2.2.2 护理组    4
2.3 低血糖处理方法    5
2.4 研究材料    5
2.5 评价标准    6
2.6 随访    6
2.7 统计方法    6
2.8 质量控制    6
3 结果    6
3.1 两组护理后对比    6
3.2两组患者的血糖、胰岛素水平比较    6
4 讨论    7
4.1 老年糖尿病患者低血糖护理后对比    7
4.2 老年糖尿病夜间低血糖的原因分析    7
4.2.1 BMI与2型糖尿病夜间低血糖    7
4.2.2 多种疾病的综合因素    8
4.2.3 老年人代谢功能降低    8
4.2.4 临床上常用的降糖药    8
4.2.5健康教育不到位    9
4.2.6夜间护理忽视    9
4.3 老年糖尿病夜间低血糖的预防    9
5 结论    11
参考文献    11