糖尿病合并肺結(jié)核患者的臨床護(hù)理和健康指導(dǎo)

論文編號(hào):HL078  論文字?jǐn)?shù):10581.頁(yè)數(shù):18

論文題目：糖尿病合并肺結(jié)核的臨床護(hù)理和健康指導(dǎo)
摘　要
 
 目的  糖尿病合并肺結(jié)核痰菌陽(yáng)性率、空洞發(fā)生率、及復(fù)發(fā)率高， 治療較單一的糖尿病或單一的肺結(jié)核困難，為了提高糖尿病合并肺結(jié)核患者療效，控制血糖，促進(jìn)痰菌陰轉(zhuǎn)和病灶吸收，減少傳染源、預(yù)防并發(fā)癥的發(fā)生。
 方法  對(duì)2008年11月—2009年8月住院的糖尿病合并肺結(jié)核患者，抽取符合條件的60名隨機(jī)分為2組，兩組在性別、年齡、病情等方面差異均無(wú)統(tǒng)計(jì)學(xué)意義,對(duì)照組30例給予常規(guī)飲食、藥物（抗結(jié)核藥物包括異煙肼、利復(fù)平 、 乙胺丁醇、吡嗪酰胺、鏈霉素，+降糖藥物包括胰島素及口服降糖藥）治療及一般的健康指導(dǎo)。實(shí)驗(yàn)組30例除常規(guī)療法外，制訂一系列有目的、有計(jì)劃的健康教育，并由專業(yè)護(hù)士進(jìn)行專門(mén)指導(dǎo)和教育。以上病人,觀察其血糖值、痰結(jié)核菌陰轉(zhuǎn)、胸部X線病灶的吸收等，兩組均按治療要求定期進(jìn)行比較和評(píng)價(jià)。
 結(jié)果  實(shí)驗(yàn)組血糖值，痰結(jié)核菌陰轉(zhuǎn)例數(shù)、胸片吸收情況均較對(duì)照組改善，經(jīng)檢驗(yàn)，均P﹤0.05,有統(tǒng)計(jì)學(xué)意義。
 結(jié)論 對(duì)糖尿病合并肺結(jié)核患者實(shí)施針對(duì)性臨床護(hù)理和健康指導(dǎo)，對(duì)控制患者血糖、體重，促進(jìn)肺部胸片病灶的吸收，痰結(jié)核菌陰轉(zhuǎn)是十分必要的。
 
 關(guān) 鍵 詞：糖尿病；結(jié)核/肺；護(hù)理；健康教育
 
 論文類(lèi)型：實(shí)驗(yàn)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  錄
 
 1緒論 1
 1.1 背景及意義 1
 1.1.1研究背景 1
 1.1.2研究意義 1
 1.2研究目的及目標(biāo) 1
 1.2.1研究目的 1
 1.2.2研究目標(biāo) 2
 1.3關(guān)鍵詞及定義 2
 1.4文獻(xiàn)回顧 2
 1.4.1糖尿病合并肺結(jié)核的發(fā)病 2
 1.4.2糖尿病合并肺結(jié)核的相互影響及對(duì)人體危害 3
 1.4.3對(duì)糖尿病合并肺結(jié)核患者實(shí)施健康教育的現(xiàn)狀和重要性 3
 1．4.4 糖尿病合并肺結(jié)核的健康教育內(nèi)容 4
 1．4.4.1 糖尿病合并肺結(jié)核的治療指導(dǎo)： 4
 1．4.4.2飲食指導(dǎo)： 4
 1．4.4.3  運(yùn)動(dòng)指導(dǎo)： 4
 1．4.4.4預(yù)防感染指導(dǎo)： 5
 1．4.4.5  做好用藥指導(dǎo)： 5
 1．4.4.6 出院指導(dǎo)： 5
 1．4.4.7 心理支持： 5
 1．4.5 糖尿病合并肺結(jié)核健康教育的效果 6
 1．4.6 健康教育存在的問(wèn)題 6
 2 研究設(shè)計(jì) 7
 2.1研究對(duì)象 7
 2.2一般資料 7
 2.3研究方法 7
 2.4研究步驟 7
 3 研究結(jié)果 8
 3．1（表1）兩組病人空腹血糖的比較（x±s） 8
 3．2（表2）兩組菌陽(yáng)病人痰結(jié)核菌陰轉(zhuǎn)情況的比較 8
 3．3（表3）兩組病人X線好轉(zhuǎn)情況的比較 8
 4 討論 9
 5 結(jié)論與展望 11
 5.1結(jié)論 11
 5.2展望 11
 致    謝 13
 參考文獻(xiàn) 14