The application effect of comprehensive nursing based on the goal theory in patients with diabetes and critical diseases in the emergency intensive care unit
以目标理论为指导的全面护理在急诊重症监护室糖尿病合并危重疾病患者中的应用效果

摘要

目的 将以目标理论为指导的全面护理用于急诊重症监护室（Emergency Intensive Care Unit, EICU）糖尿病（Diabetes Mellitus, DM）合并危重疾病患者中，对其应用效果进行分析。方法 回顾性选取2024年11月-2025年11月本院EICU收治的90例DM合并危重疾病患者临床资料进行分析，根据护理方案进行分组，对照组45例行常规ICU护理，观察组45例行以目标理论为指导的全面护理，对两组干预结果进行评价。结果 干预前，两组空腹血糖（Fasting Plasma Glucose, FPG）、餐后2h血糖（2-hour Post-load Blood Glucose, 2hPG）、糖化血红蛋白（Glycated Hemoglobin, HbA1c）水平比较，不具显著差异（P>0.05），干预后，两组各项血糖指标水平均较前明显降低，且组间两两对比，观察组各指标水平更低（P<0.05）；干预前，两组急性生理或慢性健康状况评分Ⅱ（Acute Physiology and Chronic Health Evaluation ll, APACHE Ⅱ)、生活质量量表（Short-form 36-item Health Survey, SF-36）评分比较，不具显著差异（P>0.05），干预后，观察组APACHE Ⅱ评分更低、SF-36评更高（P<0.05）；两组并发症发生率比较，观察组4.44%更低（P<0.05）。结论 对EICU收治的糖尿病合并危重疾病患者来说，应用以目标理论为指导的全面护理既能控制患者血糖水平，还可改善预后及生活质量，降低并发症发生风险，具有较高应用价值。

Abstract

Objective To apply comprehensive nursing based on the goal theory in patients with diabetes mellitus (DM) and critical illness in the emergency intensive care unit (EICU), and to analyze the application effect.
Methods The clinical data of 90 patients with DM and critical diseases who were admitted to the EICU of our hospital from November 2024 to November 2025 were retrospectively selected for analysis. The patients were grouped according to the nursing plan. The control group consisted of 45 patients who received routine ICU care, while the observation group consisted of 45 patients who received comprehensive care guided by the goal theory. The intervention results of the two groups were evaluated.
Results Before the intervention, there was no significant difference in FPG, 2hPG, and HbA1c levels between the two groups (P > 0.05). After the intervention, the levels of all blood glucose indicators in both groups were significantly lower than before, and pairwise comparisons between the groups showed that the levels of each indicator in the observation group were lower (P < 0.05); Before the intervention, there was no significant difference in APACHE II score and SF-36 score between the two groups (P > 0.05). After the intervention, the APACHE II score of the observation group was lower and the SF-36 score was higher (P < 0.05); The incidence of complications between the two groups was compared, and the incidence of the observation group was 4.44% lower (P < 0.05).
Conclusion   For patients with DM and critical illness admitted to the EICU, applying comprehensive nursing guided by the goal theory can not only control the blood glucose levels of patients, but also improve prognosis and quality of life, reduce the risk of complications, and has high application value.