糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2026.09.010

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (9): 1221-1229.DOI: 10.3761/j.issn.0254-1769.2026.09.010

糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究

王芸姣¹(), 杨玉金¹^,^*(), 郑春艳², 彭菲津², 王淑贞³, 蒋喜露³, 周为民², 王薇⁴, 张娜²

¹ 南昌大学第二附属医院护理部南昌市 330008
² 南昌大学第二附属医院血管外科南昌市 330008
³ 南昌大学护理学院南昌市 330006
⁴ 南昌大学第二附属医院内分泌科南昌市 330008

收稿日期:2025-08-08 出版日期:2026-05-10 发布日期:2026-04-30
*通讯作者: 杨玉金，E-mail：18979136718@163.com
作者简介:王芸姣：女，硕士，护师，E-mail：2730288196@qq.com
第一联系人：作者贡献声明
王芸姣：研究设计与实施、资料收集及分析、撰写论文；杨玉金：研究指导、论文审阅与修改、基金支持；郑春艳、周为民、王薇：方案构建、指导研究实施；彭菲津、王淑贞、蒋喜露、张娜：参与研究设计与实施、资料收集与整理
基金资助:
江西省卫生健康委科技计划(202510046)

Construction and application of a postoperative rehabilitation nursing program for patients with diabetic lower extremity arteriosclerosis obliterans

WANG Yunjiao¹(), YANG Yujin¹^,^*(), ZHENG Chunyan², PENG Feijin², WANG Shuzhen³, JIANG Xilu³, ZHOU Weimin², WANG Wei⁴, ZHANG Na²

¹ Department of Nursing， the Second Affiliated Hospital，Nanchang University， Nanchang 330008， China
² Department of Vascular Surgery， the Second Affiliated Hospital，Nanchang University， Nanchang 330008， China
³ the School of Nursing， Nanchang University， Nanchang 330008， China
⁴ Department of Endocrinology， the Second Affiliated Hospital，Nanchang University， Nanchang 330008， China

Received:2025-08-08 Online:2026-05-10 Published:2026-04-30
* Corresponding author: YANG Yujin，E-mail：18979136718@163.com
Funding program:
Jiangxi Provincial Health Commission Science and Technology Project(202510046)

摘要/Abstract

摘要：

目的构建糖尿病下肢动脉硬化闭塞症（diabetic lower limb arteriosclerotic obliterans，DLASO）患者介入术后康复护理方案并进行临床应用，为开展DLASO患者介入术后康复护理提供依据。方法基于健康行为过程取向（health action process approach，HAPA）模型，通过文献分析、专家函询及预试验构建干预方案。采用便利抽样法，选取2025年1—6月在南昌市某三级甲等医院血管外科行介入治疗的154例DLASO患者为研究对象，以病区为单位进行分组，通过抛硬币法确定试验组与对照组，每组各77例，试验组采用基于HAPA模型的介入术后康复护理方案，对照组给予常规护理。比较两组干预前后下肢血运、运动功能、自我管理能力、血糖相关指标及术后并发症发生率的差异。结果最终构建的方案包含3个一级条目、8个二级条目和19个三级条目。试验组74例、对照组72例完成该研究。干预3个月后，试验组下肢血运、运动功能、血糖相关指标及自我管理能力均优于对照组（均P<0.05），不同时间点两组比较，存在时间、组间及交互效应（均P<0.001）；试验组术后并发症发生率为6.76%，低于对照组的18.06%，两组比较，差异具有统计学意义（P=0.038）。结论基于HAPA模型的DLASO患者介入术后康复护理方案具有科学性和可行性，能有效增强患者下肢血运和运动功能，提升其自我管理能力，改善血糖水平，从而降低术后并发症的发生率。

关键词: 下肢动脉硬化闭塞, 糖尿病, 健康行为过程取向模型, 康复护理

Abstract:

Objective To develop and apply a rehabilitation nursing protocol for diabetic lower extremity arteriosclerotic obliterans（DLASO） patients post-intervention，and to provide a practical basis for clinical practice. Methods Based on the Health Action Process Approach（HAPA） model，an intervention protocol was developed through literature review，expert consultation，and a pilot study. A total of 154 DLASO patients receiving interventional therapy between January and June 2025 in vascular surgery departments of 2 campuses of a tertiary hospital in Nanchang were selected by convenience sampling and assigned by ward unit. Groups were determined by coin toss，with 77 patients each in an experimental group（HAPA-based rehabilitation） and a control group （routine care）. The differences in lower limb blood flow，motor function，self-management ability，blood glucose control，and complication rates were compared between the 2 groups. Results The final protocol included 3 primary items，8 secondary items，and 19 tertiary items. At the 3-month follow-up，the intervention group（74 cases） demonstrated superior outcomes in lower limb perfusion，motor function，glycemic control，and self-management（P<0.05） than the control group（72 cases），with significant time，group and interaction effects（P<0.001）. The incidence of postoperative complications in the experimental group was 6.76%，which was lower than 18.06% in the control group. A comparison between the 2 groups showed that the difference was statistically significant（P=0.038）. Conclusion The HAPA-based rehabilitation care protocol for DLASO patients is both scientific and practical. It significantly improves lower limb perfusion，motor function，self-management，and glycemic control，and thereby reducs the incidence of postoperative complications.

Key words: Lower Limb Arteriosclerosis Obliterans, Diabetes Mellitus, Health Action Process Approach Model, Rehabilitation Care

王芸姣, 杨玉金, 郑春艳, 彭菲津, 王淑贞, 蒋喜露, 周为民, 王薇, 张娜. 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1221-1229.

WANG Yunjiao, YANG Yujin, ZHENG Chunyan, PENG Feijin, WANG Shuzhen, JIANG Xilu, ZHOU Weimin, WANG Wei, ZHANG Na. Construction and application of a postoperative rehabilitation nursing program for patients with diabetic lower extremity arteriosclerosis obliterans[J]. Chinese Journal of Nursing, 2026, 61(9): 1221-1229.

图/表 8

表1 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案

Table 1 The rehabilitation care protocol for patients with DLASO after interventional surgery

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general data between 2 groups[case（percentage，%）]

表3 两组干预前后踝肱指数的比较（ $\bar{x} \pm s$）

Table 3 Comparison of ABI between 2 groups before and after intervention（ $\bar{x} \pm s$）

表4 两组干预前后无痛行走距离的比较（m，$\bar{x} \pm s$）

Table 4 Comparison of pain-free walking distance between 2 groups before and after intervention（m，$\bar{x} \pm s$）

表5 两组干预前后空腹血糖的比较（mmol/L，$\bar{x} \pm s$）

Table 5 Comparison of fasting blood glucose between 2 groups before and after intervention（mmol/L，$\bar{x} \pm s$）

表6 两组干预前后餐后2 h血糖的比较（mmol/L，$\bar{x} \pm s$）

Table 6 Comparison of 2-hour postprandial blood glucose between 2 groups before and after intervention（mmol/L，$\bar{x} \pm s$）

表7 两组干预前后糖化血红蛋白的比较（%，$\bar{x} \pm s$）

Table 7 Comparison of glycated hemoglobin between 2 groups before and after intervention（%，$\bar{x} \pm s$）

表8 两组干预前后自我管理能力的比较（分，$\bar{x} \pm s$）

Table 8 Comparison of self-management ability between 2 groups before and after intervention（scores，$\bar{x} \pm s$）

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糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究

Construction and application of a postoperative rehabilitation nursing program for patients with diabetic lower extremity arteriosclerosis obliterans

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