糖尿病骨折患者术后胰岛素泵使用中的护理风险与应对

Nursing Risks and Countermeasures in the Use of Insulin Pump after Operation for Diabetic Fracture Patients

摘要: 目的：本研究旨在探讨糖尿病骨折患者术后使用胰岛素泵过程中可能面临的护理风险，并提出相应的应对措施，以期为临床护理提供理论依据，优化糖尿病骨折患者的胰岛素管理及护理干预。方法：本研究回顾性分析了我院2024年1月到2024年12月期间，接受骨折手术治疗并使用胰岛素泵的糖尿病患者。共纳入110例患者，依据其术后胰岛素泵使用情况，分为两组：实验组(使用胰岛素泵患者，n = 55)和对照组(未使用胰岛素泵患者，n = 55)。实验组患者在术后接受胰岛素泵治疗，对照组则采用常规胰岛素注射治疗。收集患者的基础资料、术后并发症、血糖波动情况、护理风险事件(如低血糖、高血糖、泵管堵塞等)以及住院期间的其他临床指标(如血糖控制、术后恢复等)。数据通过SPSS 22.0软件进行统计分析，采用卡方检验、t检验等方法，比较两组之间的差异。结果：在110例患者中，实验组和对照组的术后血糖控制情况明显不同。实验组的术后平均血糖水平显著低于对照组(P < 0.05)。实验组在使用胰岛素泵过程中发生护理风险的事件较为频繁，主要包括泵管堵塞(7例)、泵设备故障(5例)、低血糖(9例)、高血糖(6例)等。对照组则主要发生低血糖(3例)和高血糖(2例)。统计分析结果表明，尽管胰岛素泵在血糖控制方面优于常规胰岛素注射，但其使用过程中由于设备故障或操作不当所引起的护理风险相对较高(P < 0.05)。实验组患者的住院时间较对照组显著缩短(P < 0.05)，但由于护理风险事件的发生，部分患者的恢复进程受到了影响。结论：胰岛素泵在糖尿病骨折患者术后血糖管理中具有明显优势，能够有效改善术后血糖控制水平，缩短住院时间。胰岛素泵的使用也伴随着一定的护理风险，特别是在泵管堵塞、设备故障以及低血糖、高血糖的发生方面。临床护理人员应加强对胰岛素泵的管理与监控，制定规范化的操作流程，并为患者提供详细的使用指导，以减少护理风险的发生，确保胰岛素泵的安全使用，从而提高患者的临床治疗效果。

Abstract: Objective: This study aims to explore potential nursing risks encountered by diabetic fracture patients during postoperative insulin pump use and propose corresponding countermeasures, providing theoretical basis for clinical care optimization and improving insulin management and nursing interventions for diabetic fracture patients. Methods: A retrospective analysis was conducted on diabetic patients undergoing fracture surgery with insulin pump use at our hospital from January to December 2024. A total of 110 patients were enrolled and divided into two groups based on postoperative insulin pump usage: the experimental group (55 patients using insulin pumps) and the control group (55 patients without insulin pumps). The experimental group received postoperative insulin pump therapy, while the control group underwent conventional insulin injection treatment. Data collected included baseline information, postoperative complications, blood glucose fluctuations, nursing risk events (e.g., hypoglycemia, hyperglycemia, pump tube blockage), and other clinical indicators during hospitalization (e.g., blood glucose control, postoperative recovery). Statistical analysis was performed using SPSS 22.0 software with methods such as chi-square test and t-test to compare differences between groups. Results: Significant differences in postoperative blood glucose control were observed between the two groups. The average postoperative blood glucose level in the experimental group was significantly lower than that in the control group (P < 0.05). The experimental group experienced more frequent nursing risk events during insulin pump use, including pump tube blockage (7 cases), pump equipment failure (5 cases), hypoglycemia (9 cases), and hyperglycemia (6 cases). The control group primarily experienced hypoglycemia (3 cases) and hyperglycemia (2 cases). Statistical analysis revealed that while insulin pumps demonstrated superior blood glucose control compared to conventional insulin injections, they carried relatively higher nursing risks due to equipment malfunctions or improper operation (P < 0.05). Patients in the experimental group showed significantly shorter hospital stays than the control group (P < 0.05), though some patients’ recovery progress was affected by nursing risk events. Conclusion: Insulin pumps offer distinct advantages in postoperative blood glucose management for diabetic fracture patients, effectively improving glycemic control and reducing hospitalization duration. However, their use also entails certain nursing risks, particularly concerning pump tube blockages, equipment failures, hypoglycemia, and hyperglycemia. Clinical caregivers should enhance pump management and monitoring, establish standardized operating procedures, and provide detailed user guidance to minimize nursing risks, ensure safe insulin pump usage, and ultimately improve clinical outcomes.