糖尿病合并心肌梗死卧床患者压疮的防治及护理

钟菁　张丽敏　张艺

[摘要] 目的 探讨对糖尿病合并心肌梗死卧床患者压疮的护理。 方法 对本院2013年1月～2015年1月糖尿病合并心肌梗死组58例、非糖尿病合并心肌梗死组52例进行研究，根据患者的具体情况制定护理措施（心梗急救的临床路径、压疮风险的入院评估、健康教育、饮食护理、有效的压疮预防措施、翻身运动护理、分期压疮护理等）。 结果 实施后，糖尿病组压疮发病率稍高于非糖尿病组，但两组差异没有统计学意义（P>0.05）；糖尿病组对血糖的监控、饮食控制及营养的调整护理的难度要明显高于非糖尿病组。 结论 压疮风险评估后积极的压疮预防措施、心梗患者的健康宣教、有效主动的翻身、血糖的监控调整、能够有效减低压疮发生率及促进创面的愈合。

[关键词] 糖尿病；心肌梗死；压疮

[中图分类号] R473.5 [文献标识码] B [文章编号] 2095-0616（2015）24-117-04

[Abstract] Objective To explore the nursing care of pressure sore in patients with diabetic combined with myocardial infarction. Methods 52 patients with diabetic combined with acute myocardial infarction and 58 patients of non diabetic with myocardial infarction were studied as diabetic group and non diabetic group， who were in our hospital from January 2013 to January 2015. According to the patient's specific situation， nursing measures were formulated， such as clinical pathway of myocardial infarction， admission evaluation of pressure sore risk， health education， diet nursing， effective prevention measures of pressure ulcer， the overturning movement nursing， and stage pressure sore care. Results After nursing， the incidence of pressure sore of the diabetic group was slightly higher than that of the non diabetes group， but there was no significant difference between two groups （P>0.05）. The difficulty of adjusting the blood glucose monitoring， diet control and nutrition of the diabetes group was significantly higher than that of the non diabetes group. Conclusion After the risk assessment of pressure ulcer，positive pressure ulcer prevention， health education，effective initiative and blood glucose monitoring can effectively reduce the incidence of pressure ulcers and promote wound healing.

[Key words] Diabetes； Myocardial infarction； Pressure sore

压疮是一种压力性溃疡，主要因为局部组织长期受压，发生持续缺血、缺氧而导致组织溃烂坏死。压疮是卧床患者的常见护理问题，压疮不仅给患者增加痛苦，影响疾病康复，还增加了医疗费用，延长了住院时间。皮肤压疮经久不愈，常导致许多并发症，有文献报道，每年有近6万人死于压疮合并症。据统计[1]，老年患者压疮的发生率为10%～25%。急性心肌梗死是冠心病的急重症，合并糖尿病时更加重压疮发生的危险性。据报道， 糖尿病合并心肌梗死患者的死亡率是非糖尿病的1.5～2倍[2]。因此，对糖尿病合并心肌梗死卧床患者的压疮防治及护理显得极为重要。