中华护理杂志 ›› 2024, Vol. 59 ›› Issue (16): 1987-1992.DOI: 10.3761/j.issn.0254-1769.2024.16.010

• 专科护理实践与研究 • 上一篇    下一篇

肺移植患者移植后糖尿病的影响因素分析及护理启示

蔡凌云(), 曾妃(), 郭璐瑶, 兰美娟, 梁江淑渊, 顾培培, 朱岩, 郭鸽   

  1. 310000 杭州市 浙江大学医学院附属第二医院护理部
  • 收稿日期:2023-08-23 出版日期:2024-08-20 发布日期:2024-08-12
  • 通讯作者: 曾妃,E-mail:zengfei@zju.edu.cn
  • 作者简介:蔡凌云:女,硕士,护师,E-mail:2521114@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技计划项目(2024KY1093)

Analysis and nursing enlightenment of influencing factors of post-transplant diabetes mellitus in lung transplant recipients

CAI Lingyun(), ZENG Fei(), GUO Luyao, LAN Meijuan, LIANG Jiangshuyuan, GU Peipei, ZHU Yan, GUO Ge   

  • Received:2023-08-23 Online:2024-08-20 Published:2024-08-12

摘要:

目的 研究成人肺移植患者移植后糖尿病(post-transplant diabetes mellitus,PTDM)的发生情况及其影响因素。 方法 采取便利抽样法,回顾性分析浙江省杭州市某三级甲等综合医院肺移植科2020年1月—2022年12月肺移植患者的临床资料。根据PTDM诊断标准,将肺移植患者分为PTDM组与非PTDM组,统计PTDM发生率,采用单因素及多因素Logistic回归方法分析发生PTDM的影响因素。 结果 共纳入140例患者,肺移植患者6个月内发生PTDM共54例,发生率为38.57%。单因素分析显示,两组年龄、性别、BMI、吸烟史、术前糖化白蛋白、术前空腹血糖、术后早期血糖、术前肌酐比较,差异具有统计学意义(P<0.05)。Logistic回归分析显示,性别(OR=5.283)、BMI(OR=6.122)、术前糖化白蛋白(OR=1.330)、术后早期血糖(OR=1.444)是其影响因素。 结论 男性、BMI≥24.0、术前糖化白蛋白高、术后早期血糖高的肺移植患者发生PTDM的风险更高。临床护理人员可根据影响因素制订相关护理措施,预防PTDM的发生。

关键词: 肺移植, 移植后糖尿病, 影响因素分析, 护理

Abstract:

Objective To investigate the incidence and risk factors of post-transplant diabetes mellitus(PTDM) in adult lung transplant recipients. Methods Conducting a convenience sampling method,we retrospectively analyzed the clinical data of lung transplant recipients from January 2020 to December 2022 at a tertiary A hospital in Hangzhou,Zhejiang Province. According to the PTDM diagnostic criteria,lung transplant recipients are divided into a PTDM group and a non-PTDM group. The incidence rate of PTDM is calculated,and the influencing factors for PTDM occurrence are analyzed using both univariate and multivariate logistic regression methods. Results A total of 140 patients were included in this study,and 54 lung transplant recipients developed PTDM within 6 months,with an incidence of 38.57%. Univariate analysis showed that there were significant differences in age,gender,BMI,smoking history,pre-operative glycated albumin,pre-operative fasting blood glucose,early post-operative blood glucose and pre-operative creatinine between the 2 groups(P<0.05). Multivariate Logistic analysis showed that gender (OR=5.283),BMI(OR=6.122),pre-operative glycated albumin(OR=1.330),and early post-operative blood glucose(OR=1.444) were the influencing factors. Conclusion Lung transplant recipients who were male,BMI≥24.0,with high levels of glycated albumin before surgery,and high blood sugar early after surgery had a higher risk of developing PTDM. Clinical nurses can formulate relevant nursing measures according to the influencing factors to prevent the occurrence of PTDM.

Key words: Lung Transplantation, Post-Transplant Diabetes Mellitus, Root Cause Analysis, Nursing Care