糖尿病合并慢性乙型肝炎患者的护理模式研究进展

Research Progress on Nursing Models for Patients with Diabetes Mellitus Complicated with Chronic Hepatitis B

摘要: 糖尿病合并慢性乙型肝炎是一种复杂的共病状态，患者同时面临血糖代谢紊乱和肝脏功能受损的双重挑战，临床管理难度显著增加。本文系统综述了该共病状态的护理模式研究进展。有证据显示，以医院为主的延续护理模式通过远程随访可降低25%再入院率，但资源消耗较大；社区护理模式(如“俱乐部”式教育)提升15%自我管理能力且成本效益显著，但对急重症支持有限；中医情志护理基于“肝主疏泄”理论使焦虑评分降低30%；在技术接受度较高的患者群体中，互联网 + 5A护理模式展现出巨大潜力。有临床观察性研究报道，通过整合智能技术与系统化5A步骤，干预组患者的血糖达标率相较于常规护理组可提升逾40%；有证据表明，循证护理模式可降低40%药物性肝损伤风险，对专业素养要求较高。未来需关注多模式整合、基层能力提升及个性化护理策略。本研究为优化糖尿病合并慢性乙型肝炎的护理实践提供了理论支持和实践方向。

Abstract: Diabetes mellitus combined with chronic hepatitis B represents a complex comorbid condition, where patients face the dual challenges of disordered glucose metabolism and impaired liver function, significantly increasing the difficulty of clinical management. This article systematically reviews recent advances in nursing models for this comorbid state. Evidence indicates that hospital-based continuity of care models can reduce readmission rates by 25% through remote follow-up, albeit with substantial resource consumption; community nursing models (e.g., “club-style” education) enhance self-management ability by 15% with notable cost-effectiveness, yet provide limited support for acute and critical conditions; Traditional Chinese Medicine emotional nursing, grounded in the theory of “the liver governing conveyance and dispersion”, reduces anxiety scores by 30%. Among patients with higher technology acceptance, the Internet + 5A nursing model demonstrates significant potential. Clinical observational studies report that integrating intelligent technology with systematic 5A steps can increase the rate of achieving target blood glucose levels by over 40% in the intervention group compared to usual care. Furthermore, evidence suggests that the evidence-based nursing model can reduce the risk of drug-induced liver injury by 40%, though it demands high professional competence. Future efforts should focus on multimodal integration, enhancement of primary care capabilities, and personalized nursing strategies. This study provides theoretical support and practical direction for optimizing nursing practice in patients with diabetes mellitus and chronic hepatitis B.