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Objective:To analyze and compare the demographic and clinical characteristics of patients with different types of hyperglycemic crisis, so as to provide clinical basis for the prevention and treatment of hyperglycemic crisis.Methods:The data of patients with hyperglycemic crisis in six First-level general hospitals in Chongqing from Jan. 2015 to Dec. 2020 were retrospectively collected and divided into diabetic ketoacidosis (DKA) , hyperglycemic hyperosmolar state (HHS) and diabetic ketoacidosis with hyperglycemic hyperosmotic state (DKA-HHS) . The demographic and clinical characteristics of each group were analyzed by descriptive method.Results:A total of 1668 patients were collected, among whom1388 were DKA, 113 were HHS and 167 were DKA-HHS. The proportion of T2DM in DKA was 90.1%, the proportion of urban residents’ medical insurance, farmers and retirees was higher in the three groups, and the incidence of hyperglycemic crisis in patients above 60 years old was the highest in all age groups. The incidence of DKA and HHS changed little during the six years, but increased significantly in the DKA-HHS group. Shock, disturbance of consciousness, hospitalization expenses and mortality in the DKA-HHS group were higher than those in the other two groups.Conclusions:There are differences in demographic and clinical characteristics among different types of hyperglycemic crisis. Clinically, more attention should be paid to patients above 60 years old and patients with hyperglycemic crisis such as DKA-HHS. Health education and guidance for diabetic patients in high-risk groups should be strengthened in order to reduce the occurrence of diabetic hyperglycemic crisis.
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Objective:To construct a reasonable and efficient clinical nursing pathway for elderly patients with acute chest pain in the emergency department, and to provide a standardized and rapid treatment process for such patients.Methods:Through literature review and theoretical analysis, the basic framework of clinical nursing pathway was preliminarily drawn up. Twenty one clinical medical and nursing experts from all over the country were selected to conduct two rounds of expert consultation with Delphi method, and the clinical nursing path was finally determined.Results:The recovery rates of the two rounds of questionnaires were 100.00% and 95.24%, and the rates of submission expert suggestions were 61.90% and 45.00%, the authority coefficients of experts were 0.85 and 0.88, and the coordination coefficients were 0.23 and 0.30. Finally, the clinical nursing pathway was constructed after two rounds of consultation.Conclusion:The positive coefficient and authority coefficient of the two rounds of experts were both high, and the variable coefficient and coordination coefficient were in line with the statistical requirements, so the clinical nursing path of the elderly patients with acute chest pain had high scientificity and reliability.
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Objective:Comparison of oxygen therapy effect between three different enteral nutrition solutions was carried out on AECOPD patients with non-invasive ventilation.Methods:A total of 96 patients with acute exacerbation of COPD were divided into three groups of 32 respectively according to the admission order in this prospective study:a continuous feeding group,an intermittent feeding group,and a regular bolus feeding group.Arterial blood gas parameters including PH,PaO2,PaCO2,PaO2/FiO2 of three groups on third day,fifth day,seventh day were recorded and compared to evaluate the enteral nutrition effect,and meanwhile nutritional support costs,duration of mechanical ventilation,and length of ICU stay between groups were also studied.Results:PH Values of continuous feeding group and intermittent feeding group on 7th day are7.38 ± 0.04、7.39 ± 0.01 respectively,better than that of regular bolus feeding group (P＜ 0.05).ICU stay period and duration of mechanical ventilation for continuous feeding group are 12.83 ± 3.00 days and 9.50 ± 1.45 respectively,for the intermittent feeding group are 11.90 ± 2.35 and 9.59 ± 1.50 respectively,the two groups gain significant cost-effective advantages compared to the regular bolus feeding group.(P ＜ 0.05),for nutrition support costs,continuous feeding is less than the intermittent feeding.(.P ＜ 0.05).Conclusion:Continuous feeding and intermittent feeding could significantly improve hypoxia symptom and reduce the length of ICU stay and shorten duration of mechanical ventilation in COPD patients compared with regular bolus feeding group.