五指定位联合时间轮换法对居家胰岛素注射患者的治疗效果

目的探讨五指定位联合时间轮换法对居家胰岛素注射患者的治疗效果。方法 2014年5月至2015年8月,便利抽样法选取在江苏省南通市某三甲医院内分泌科门诊就诊,首次进行胰岛素注射的患者100例为研究对象。按随机数字表法将其分为对照组和观察组,每组50例。所有患者均每日早、晚两次注射胰岛素。对照组患者采用指南推荐的四个象限注射部位轮换方法,而观察组患者采用五指定位联合时间轮换法。7天为一周期,共随访6个月。在干预1、3、6个月后,观察两组患者注射部位轮换的执行率、局部皮肤的不良反应发生情况,以及干预后的糖化血红蛋白的变化。结果干预1、3、6个月后,观察组患者注射部位轮换执行率分别为100%(50/50)、94%(47/50)、86%(43/50),分别高于对照组的92%(46/50)、78%(39/50)、50%(25/50),差异均有统计学意义(均P0.05)。干预1个月后,两组患者中分别有2例患者发生局部不良反应,差异无统计学意义(P0.05);干预3个月后,对照组有9例患者(18%)发生局部不良反应,而观察组仅有4例患者(8%),差异有统计学意义(P0.05);干预6个月后,对照组有13例患者发生局部不良反应(26%),而观察组有5例患者(10%),差异亦有统计学意义(P0.05)。两组患者干预后的糖化血红蛋白相比差异无统计学意义(P0.05)。结论改进的五指定位联合时间轮换法在胰岛素注射中,较传统的四个象限注射部位轮换方法更方便、实用,患者注射部位轮换的依从性高,局部反应的发生率明显下降。

Therapeutic Effect of Five-finger Locating plus Time Rotation on Community-dwelling Insulin-injected Patients

Objective To study the efficacy of five-finger locating plus time rotation on comrunity-dwelling insulin-injected patiens.By convenience sampling,100 cases were selected and randomly divided into control group and observation group,with 50 cases in each group.All patients were injected insulin twice a day,in the morning and at night,with the control group receiving the recommended site-rotational four quadrant injections and the observing group guided by the fivefinger location plus time rotation.Each follow-up lasts for 7 days,with a total adding upto 6 months.The implementation rate,the adverse reactions of the localized skins as well as the glycosylated hemoglobin alterations in both groups were checked at the first,the third and the sixth month respectively.Results As the treatment lasts for 1,3 and 6 months,the implementation rates of the site-rotational injection in the observation group were respectively 100％(50/50),94％(47/50),86％(43/50),being relatively higher than those found in the control group:92％(46/50),78％(39/50),50％(25/50).Each difference is statistically significant (all P＜0.05).One month after the interference,two cases d skin adverse reactions occurred in both groups,showing no statistical significance (P＞0.05);three month after the injections,9 cases from the control group developed localized adverse reactions(18％),whereas only 4 cases of adverse reactions were found in the observation group (8％),which was statistically significant (P＜0.05);And after 6 month's treatment,13 cases d adverse reactions were found in the control group(26％),which outnumbered the 5 cases(10％) in the other group and was statistically significant (P＜0.05).However,the difference in the glycosylated hemoglobin levels between the two groups showed no statistical significance(P＞0.05).Conclusion In contrast,the five-finger locating plus the time rotation method is found to be more convenient and more practically important,showing better compliances in implementation and less the occurrences d the adverse reactions.