糖尿病合并肺结核患者的临床护理和健康指导

论文编号:HL078  论文字数:10581.页数:18

论文题目：糖尿病合并肺结核的临床护理和健康指导
摘　要
 
 目的  糖尿病合并肺结核痰菌阳性率、空洞发生率、及复发率高， 治疗较单一的糖尿病或单一的肺结核困难，为了提高糖尿病合并肺结核患者疗效，控制血糖，促进痰菌阴转和病灶吸收，减少传染源、预防并发症的发生。
 方法  对2008年11月—2009年8月住院的糖尿病合并肺结核患者，抽取符合条件的60名随机分为2组，两组在性别、年龄、病情等方面差异均无统计学意义,对照组30例给予常规饮食、药物（抗结核药物包括异烟肼、利复平 、 乙胺丁醇、吡嗪酰胺、链霉素，+降糖药物包括胰岛素及口服降糖药）治疗及一般的健康指导。实验组30例除常规疗法外，制订一系列有目的、有计划的健康教育，并由专业护士进行专门指导和教育。以上病人,观察其血糖值、痰结核菌阴转、胸部X线病灶的吸收等，两组均按治疗要求定期进行比较和评价。
 结果  实验组血糖值，痰结核菌阴转例数、胸片吸收情况均较对照组改善，经检验，均P﹤0.05,有统计学意义。
 结论 对糖尿病合并肺结核患者实施针对性临床护理和健康指导，对控制患者血糖、体重，促进肺部胸片病灶的吸收，痰结核菌阴转是十分必要的。
 
 关 键 词：糖尿病；结核/肺；护理；健康教育
 
 论文类型：实验性研究
 
 
 
Title: Clinical care and health guidance of diabetes patient with tuberculosis
 ABSTRACT 
Objectives: It is easy for the diabetes patient with tuberculosis to cause positive  sputum ,incidence of  cavitation  and high rate of relapse. And it is harder to cure to the  isolated diabetes or tuberculosis. To improve healing efficacy of diabetes patient with tuberculosis,    we should to control blood glucose ,promote sputum negative conversion , focus absorption ,reduce reservoir and prevent complication occurrence.   
Methods: 60 diabetes patients with tuberculosis in hospital from November 2008 to August 2009 were divided into to groups at random pair. There was no statistically significant difference in sex, age and patient''''s condition. 30 cases of control group were gave diets , medication (antitubercular agent include retozide, rifampicin, ethambutol , pyrazinamide , streptomycin, insulin and OHA) and generic health guidance. Except for routine treatment , 30 cases of experimental group was given a series of purposive and prepense of health education.And these were guided and educated by Professional nurses. Then we observed these patients of blood sugar , sputum negative conversion and focus absorption of chest X –ray. The two groups was compared and evaluated at regular intervals. 
Results: The experimental group was better in blood sugar , cases of sputum negative conversion and focus absorption than the control group. It had  statistical significance(p<0.05).
Conclusion: It was essential to implement clinical care and health guidance for the diabetes patient with tuberculosis .And it was very necessary to control blood glucose and weight of the patients and to promote focus absorption.

Key Words: diabetes; tuberculosis ; nurse ; health education

Type of THesis: experimental study

 目  录
 
 1绪论 1
 1.1 背景及意义 1
 1.1.1研究背景 1
 1.1.2研究意义 1
 1.2研究目的及目标 1
 1.2.1研究目的 1
 1.2.2研究目标 2
 1.3关键词及定义 2
 1.4文献回顾 2
 1.4.1糖尿病合并肺结核的发病 2
 1.4.2糖尿病合并肺结核的相互影响及对人体危害 3
 1.4.3对糖尿病合并肺结核患者实施健康教育的现状和重要性 3
 1．4.4 糖尿病合并肺结核的健康教育内容 4
 1．4.4.1 糖尿病合并肺结核的治疗指导： 4
 1．4.4.2饮食指导： 4
 1．4.4.3  运动指导： 4
 1．4.4.4预防感染指导： 5
 1．4.4.5  做好用药指导： 5
 1．4.4.6 出院指导： 5
 1．4.4.7 心理支持： 5
 1．4.5 糖尿病合并肺结核健康教育的效果 6
 1．4.6 健康教育存在的问题 6
 2 研究设计 7
 2.1研究对象 7
 2.2一般资料 7
 2.3研究方法 7
 2.4研究步骤 7
 3 研究结果 8
 3．1（表1）两组病人空腹血糖的比较（x±s） 8
 3．2（表2）两组菌阳病人痰结核菌阴转情况的比较 8
 3．3（表3）两组病人X线好转情况的比较 8
 4 讨论 9
 5 结论与展望 11
 5.1结论 11
 5.2展望 11
 致    谢 13
 参考文献 14