Nursing Experience of Glycemic Control for Patients with Rheumatic Heart Disease Combined with Diabetes after Valve Replacement_West China Medical Journal

Authors：

 LIBi-lan , SHIRong

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

Rheumatic heart disease; Diabetes; Heart valve replacement; Blood glucose monitoring

DOI：

10.7507/1002-0179.20140641

Video：

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Objective To summarize the monitoring experiences of blood glucose for patients with rheumatic heart disease combined with diabetes, in order to prevent postoperative complications caused by abnormal blood sugar, relieve pain and promote rehabilitation. Methods We reviewed the medical records of the patients with diabetes after heart valve replacement who were admitted to our department from April 2011 to March 2012. Eighty patients were randomly divided into observation group and control group with 40 in each group. Patients in the control group received conventional treatment with subcutaneous insulin injection, while the observation group patients were treated with intravenous insulin pump, and the dose of insulin was adjusted depending on blood glucose levels. Then we compared the postoperative changes in blood glucose level and complications between the two groups. Results The insulin dose, the time of reaching target blood glucose levels, hospital stays and postoperative complication rates were significantly lower in the observation group than the control group (P<0.05). During the one-year follow-up after operations, 2 and 4 patients died respectively in the observation group and the control group, and the difference was not significant (χ²=0.180, P=0.670). Conclusion For patients with diabetes after heart valve replacements, intravenous insulin pump is better than subcutaneous insulin injection. It can prevent complications, shorten hospital stays, reduce financial burden, and promote prognosis and harmonious doctor-patient relationship.

Citation： LIBi-lan, SHIRong. Nursing Experience of Glycemic Control for Patients with Rheumatic Heart Disease Combined with Diabetes after Valve Replacement. West China Medical Journal, 2014, 29(11): 2128-2131. doi: 10.7507/1002-0179.20140641 Copy

1.	Corney SM, Dukatz T, Rosenblatt S, et al. Comparison of insulin pump therapy (continuous subcutaneous insulin infusion) to alternative methods for perioperative glycemic management in patients with planned postoperative admissions[J]. J Diabetes Sci Technol, 2012, 6(5):1003-1015.
2.	蘇陽. 糖尿病及并發癥的護理體會[J]. 大家健康·中旬版, 2012, 6(1):40-41.
3.	紀曉暉,李娜.老年糖尿病人工瓣膜置換術27例圍術期護理[J]. 齊魯護理雜志, 2010, 16(17):60-61.
4.	林江.低嘌呤糖尿病飲食對痛風合并2型糖尿病的療效觀察[J]. 實用醫學雜志, 2009, 25(18):3083-3084.
5.	李明秀, 王建. 血糖生成指數與糖尿病飲食管理[J]. 腸外與腸內營養, 2005, 12(5):303-305.
6.	胡宇鵬. 糖尿病飲食知識教育與飲食治療依從性相關性研究[J]. 當代醫學, 2012(30):100-101.
7.	渠海靜. 胰島素泵強化治療2型糖尿病的臨床觀察[J]. 內蒙古中醫藥, 2012, 31(10):80-81.
8.	黃園琴, 饒丹, 龍艷麗. 胰島素泵在并發2型糖尿病的冠狀動脈旁路成形術患者圍手術期的應用[J]. 醫藥導報, 2012, 31(6):735-737.
9.	Studer C, Sankou W, Penfornis A, et al. Efficacy and safety of an insulin infusion protocol during and after cardiac surgery[J]. Diabetes Metab, 2010, 36(1):71-78.
10.	曹琴,張偉英,侯明君, 等. 糖尿病患者心臟瓣膜置換術后監護[J]. 解放軍護理雜志, 2000, 17(4):38-39.
11.	Haveman JW, Logtenberg SJ, Kleefstra N, et al. Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump[J]. Langenbecks Arch Surg, 2010, 395(1):65-71.
12.	邢倩, 白然, 蔣召芹, 等. 短期胰島素泵強化治療對初診2型糖尿病患者預后及胰島β細胞功能的影響[J]. 大連醫科大學學報, 2012, 34(3):274-276, 296.
13.	黃積平, 林宏彩, 馮劍華, 等. 糖尿病患者行二尖瓣置換術的術后護理[J]. 護士進修雜志, 2010, 25(16):1520-1521.
14.	陶紅. 37例糖尿病患者心臟瓣膜置換術后血糖控制的護理[J]. 當代護士·學術版, 2012(1):25-26.
15.	張媛媛, 姚琴, 鄭暉. 糖尿病酮癥酸中毒的護理體會[J].中國社區醫師·醫學專業, 2012, 14(14):321.
16.	Nassar AA, Boyle ME, Seifert KM, et al. Insulin pump therapy in patients with diabetes undergoing surgery[J]. Endocr Pract, 2012, 18(1):49-55.

1. Corney SM, Dukatz T, Rosenblatt S, et al. Comparison of insulin pump therapy (continuous subcutaneous insulin infusion) to alternative methods for perioperative glycemic management in patients with planned postoperative admissions[J]. J Diabetes Sci Technol, 2012, 6(5):1003-1015.
2. 蘇陽. 糖尿病及并發癥的護理體會[J]. 大家健康·中旬版, 2012, 6(1):40-41.
3. 紀曉暉,李娜.老年糖尿病人工瓣膜置換術27例圍術期護理[J]. 齊魯護理雜志, 2010, 16(17):60-61.
4. 林江.低嘌呤糖尿病飲食對痛風合并2型糖尿病的療效觀察[J]. 實用醫學雜志, 2009, 25(18):3083-3084.
5. 李明秀, 王建. 血糖生成指數與糖尿病飲食管理[J]. 腸外與腸內營養, 2005, 12(5):303-305.
6. 胡宇鵬. 糖尿病飲食知識教育與飲食治療依從性相關性研究[J]. 當代醫學, 2012(30):100-101.
7. 渠海靜. 胰島素泵強化治療2型糖尿病的臨床觀察[J]. 內蒙古中醫藥, 2012, 31(10):80-81.
8. 黃園琴, 饒丹, 龍艷麗. 胰島素泵在并發2型糖尿病的冠狀動脈旁路成形術患者圍手術期的應用[J]. 醫藥導報, 2012, 31(6):735-737.
9. Studer C, Sankou W, Penfornis A, et al. Efficacy and safety of an insulin infusion protocol during and after cardiac surgery[J]. Diabetes Metab, 2010, 36(1):71-78.
10. 曹琴,張偉英,侯明君, 等. 糖尿病患者心臟瓣膜置換術后監護[J]. 解放軍護理雜志, 2000, 17(4):38-39.
11. Haveman JW, Logtenberg SJ, Kleefstra N, et al. Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump[J]. Langenbecks Arch Surg, 2010, 395(1):65-71.
12. 邢倩, 白然, 蔣召芹, 等. 短期胰島素泵強化治療對初診2型糖尿病患者預后及胰島β細胞功能的影響[J]. 大連醫科大學學報, 2012, 34(3):274-276, 296.
13. 黃積平, 林宏彩, 馮劍華, 等. 糖尿病患者行二尖瓣置換術的術后護理[J]. 護士進修雜志, 2010, 25(16):1520-1521.
14. 陶紅. 37例糖尿病患者心臟瓣膜置換術后血糖控制的護理[J]. 當代護士·學術版, 2012(1):25-26.
15. 張媛媛, 姚琴, 鄭暉. 糖尿病酮癥酸中毒的護理體會[J].中國社區醫師·醫學專業, 2012, 14(14):321.
16. Nassar AA, Boyle ME, Seifert KM, et al. Insulin pump therapy in patients with diabetes undergoing surgery[J]. Endocr Pract, 2012, 18(1):49-55.

West China Medical Journal

Nursing Experience of Glycemic Control for Patients with Rheumatic Heart Disease Combined with Diabetes after Valve Replacement

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