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.	苏阳. 糖尿病及并发症的护理体会[J]. 大家健康·中旬版, 2012, 6(1):40-41.
3.	纪晓晖,李娜.老年糖尿病人工瓣膜置换术27例围术期护理[J]. 齐鲁护理杂志, 2010, 16(17):60-61.
4.	林江.低嘌呤糖尿病饮食对痛风合并2型糖尿病的疗效观察[J]. 实用医学杂志, 2009, 25(18):3083-3084.
5.	李明秀, 王建. 血糖生成指数与糖尿病饮食管理[J]. 肠外与肠内营养, 2005, 12(5):303-305.
6.	胡宇鹏. 糖尿病饮食知识教育与饮食治疗依从性相关性研究[J]. 当代医学, 2012(30):100-101.
7.	渠海静. 胰岛素泵强化治疗2型糖尿病的临床观察[J]. 内蒙古中医药, 2012, 31(10):80-81.
8.	黄园琴, 饶丹, 龙艳丽. 胰岛素泵在并发2型糖尿病的冠状动脉旁路成形术患者围手术期的应用[J]. 医药导报, 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,张伟英,侯明君, 等. 糖尿病患者心脏瓣膜置换术后监护[J]. 解放军护理杂志, 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, 蒋召芹, 等. 短期胰岛素泵强化治疗对初诊2型糖尿病患者预后及胰岛β细胞功能的影响[J]. 大连医科大学学报, 2012, 34(3):274-276, 296.
13.	黄积平, 林宏彩, 冯剑华, 等. 糖尿病患者行二尖瓣置换术的术后护理[J]. 护士进修杂志, 2010, 25(16):1520-1521.
14.	陶红. 37例糖尿病患者心脏瓣膜置换术后血糖控制的护理[J]. 当代护士·学术版, 2012(1):25-26.
15.	张媛媛, 姚琴, 郑晖. 糖尿病酮症酸中毒的护理体会[J].中国社区医师·医学专业, 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. 苏阳. 糖尿病及并发症的护理体会[J]. 大家健康·中旬版, 2012, 6(1):40-41.
3. 纪晓晖,李娜.老年糖尿病人工瓣膜置换术27例围术期护理[J]. 齐鲁护理杂志, 2010, 16(17):60-61.
4. 林江.低嘌呤糖尿病饮食对痛风合并2型糖尿病的疗效观察[J]. 实用医学杂志, 2009, 25(18):3083-3084.
5. 李明秀, 王建. 血糖生成指数与糖尿病饮食管理[J]. 肠外与肠内营养, 2005, 12(5):303-305.
6. 胡宇鹏. 糖尿病饮食知识教育与饮食治疗依从性相关性研究[J]. 当代医学, 2012(30):100-101.
7. 渠海静. 胰岛素泵强化治疗2型糖尿病的临床观察[J]. 内蒙古中医药, 2012, 31(10):80-81.
8. 黄园琴, 饶丹, 龙艳丽. 胰岛素泵在并发2型糖尿病的冠状动脉旁路成形术患者围手术期的应用[J]. 医药导报, 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,张伟英,侯明君, 等. 糖尿病患者心脏瓣膜置换术后监护[J]. 解放军护理杂志, 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, 蒋召芹, 等. 短期胰岛素泵强化治疗对初诊2型糖尿病患者预后及胰岛β细胞功能的影响[J]. 大连医科大学学报, 2012, 34(3):274-276, 296.
13. 黄积平, 林宏彩, 冯剑华, 等. 糖尿病患者行二尖瓣置换术的术后护理[J]. 护士进修杂志, 2010, 25(16):1520-1521.
14. 陶红. 37例糖尿病患者心脏瓣膜置换术后血糖控制的护理[J]. 当代护士·学术版, 2012(1):25-26.
15. 张媛媛, 姚琴, 郑晖. 糖尿病酮症酸中毒的护理体会[J].中国社区医师·医学专业, 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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