Persistent state of asthma clinical observation and the nursing, relation result in 0 patients with diabetic foot nursing experience. 1 Clinical data of 1.1 general information: 20 cases of diabetic foot patients, male 11, female 9, age 38 ~ 75 years old, Franklin Marsh femme, average 45 years old. History of diabetes 8 to 28 years, mean 14.5 years. Admission average fasting blood glucose 11.6mmol / L, 2h postprandial plasma glucose average 17.2mmol / L. The dry gangrene in 2 cases, mixed gangrene in 15 cases, wet gangrene in 3 cases; gangrenous place respectively toes and feet at the bottom, manifested as skin temperature decreased, artery reduced volatility, skin erosion, ulcer skin secretions, dark brown, black.
In 1.2 ways: 1 hypoglycemic therapy: In 20 cases, 15 patients using short-acting insulin plus oral antidiabetic therapy, 3 patients using short-acting and long-acting insulin plus oral antidiabetic therapy. Anti-infective therapy...: In this group of cases of mixed infection, 16 cases with broad-spectrum antibiotics and metronidazole, 4 cases of oral broad-spectrum antibiotic drug therapy. Mechanical pad: Relieve ulcer with partial weight-bearing, limb elevation 30 .~ 40.
Results: 1.3 of 20 cases treated by comprehensive treatment and nursing of glycemic control compared with 7.0 mmol / L, fasting blood glucose. Cured, 15 cases improved, 3 cases with dry feet, wound area reduced, 2 cases of death.
Nursing care of 2.1 blood glucose control: 2 patients with diabetes control blood glucose levels can reduce microvascular and arterial vascular injury, improve tissue ischemia and hypoxia, so that the skin protection and defense function enhancement. Nurses need to understand the patient, regular monitoring, provide a reliable clinical data for the treatment.
2.2 Local medication: Immersion and external J, applied to the wet and mixed, gangrene in size and position using 500 - 1000ml saline + HCl gentamicin + insulin soak 20 ~ 30min, or local wet dressing gauze. Insulin in early may improve the function of leukocytes, especially chemical skin, phagocytosis and intracellular killing.
2.3 Mechanical pad: Relieve ulcer with partial weight-bearing, bed limb elevation 30 .~ 40., using crutches, wear special shoes. Shoes for a long period, before the shoes to check the shoes with no foreign body. Socks choose not too tight so as not to affect the blood flow, should choose good moisture absorption and no stimulation to the skin smooth, soft cotton socks.
3 Discussion: This group of 20 patients treated by effective nursing, satisfactory effect. This can shorten the hospitalization time, save money, reduce the suffering of patients, improve the quality of life of patients. Diabetic foot can be treated and controlled, but all will give patients suffering in different degrees. Therefore, to control the occurrence of diabetic foot with emphasis on prevention, and prevention is the key to health education. Health education is intended to give the patients, self-management ability has been improved, preventing the occurrence of diabetic foot.
3.1 Active prevention of foot trauma: Reduce injuries and risk factors is the prevention of foot ulcer basic measure, prohibit barefoot and wearing slippers, sandals walking, so as not to damage the foot J. Trim toenails in immersion is soft trim, don't too close to the skin. Reduce foot small vein puncture opportunity, preventing foot drying, cracking, keep clean.
3.2 Strengthening inspection: Since foot insensitivity or disorder, patients with pain, heat, pressure, discomfort is not clear perception, so patients should have checked daily foot habits, attention to whether the blister and skin abrasions, regularly to the hospital for foot comprehensive examination, pay attention to whether the occurrence of foot ulcer risk factors, preventive nursing measures.
3.3 Psychological nursing: Diabetes mellitus complicated the clinical course, treatment for a long time, the occurrence and development of diabetic foot is a chronic process, giving patients a heavy psychological burden and mental stress. First of all let patients about diabetes mellitus is a systemic disease, allowing patients to establish the confidence to overcome the disease, knowledge about diabetes mellitus relationship with the daily life, do not worry too much about. Learn to overcome the disease self-management is the important basis.
3.4 Removing predisposing factors of foot skin disease in patients with diabetes mellitus complicated with diabetic foot frequent predisposing factors, so we should actively prevention and therapy of fungal foot infections and other diseases of the skin, in order to achieve the aim of prevention of diabetic foot.
3.5 Exercise: Exercise to enhance muscle on insulin sensitivity, thereby accelerating the glucose utilization, good glycemic control, but also can promote the body particularly limb blood circulation, so as to achieve the purpose of J prevention of diabetic foot.
3.6 Strengthening the health education: Most of the patients on diabetes foot concept unclear, the foot can not give effective self care, even can not be timely to the hospital. Therefore strengthening the education to improve patients consciousness of self protection is very important. All patients with diabetes should receive podiatry care and prevention of diabetic foot by education, including the enhancement of diabetic foot prevention awareness, how to distinguish sensory.