摘要
目的调查南通市二级医院糖尿病患者的住院管理现状,探讨开展糖尿病诊断与治疗质量控制的必要性。方法随机抽取276份以2型糖尿病为第一诊断的病历,根据《中国糖尿病防治指南》(2004)对糖尿病控制管理的基本要求,对住院病历进行糖尿病住院管理登记调查。结果①代谢指标与体格检查指标:糖化血红蛋白、血脂、血压、身高、体重及腰围的检查率分别为38.0%、81.9%、98.9%、9.8%、52.9%和4.0%,平均血糖监测次数为(3.6±2.4)次/d。②糖尿病慢性并发症筛查:心电图、心脏超声、血管超声、肾功能、尿微量白蛋白、眼底以及下肢神经的检查率分别为83.0%、22.1%、27.9%、94.9%、33.0%、23.9%和8.0%。③综合治疗与生活方式干预:抗高血压、调节血脂以及阿司匹林使用率分别为80.1%、40.6%和29.1%;仅6.9%的出院医嘱含有饮食治疗指导计划,出院运动治疗指导率仅为0.7%。④出院时代谢指标及血压的治疗达标率:血糖控制理想率、降压治疗达标率分别为23.9%和20.8%。结论糖尿病患者住院管理的质量亟待提高,很有必要加强糖尿病防治工作的质量控制。
Objective To investigate the management of the diabetic in-patients in class Ⅱ hospitals and to discuss the necessity of more emphasis on diagnosis,treatment,and quality control of diabetes mellitus.Methods The case records of 276 patients with type 2 diabetes mellitus were randomly chosen from 18 class Ⅱ hospitals in Nantong area.Based on the principle Guideline For Prevention and Treatment of Diabetes in China（2004）,we investigated case records of these patients.Results ① Examination of anthropometric measurement and metabolic profile：The percents of patients who had undergone examination of HbA1c,lipoprotein profile,blood pressure,body height,body weight,and waist circumference were 38.0%,81.9%,98.9%,9.8%,52.9% and 4.0%,respectively.The mean blood glucose monitor frequency was only（3.6±2.4） times/day.② Screen for chronic diabetic complications：The percents of patients who had undergone electrocardiograghy,echocardiography,vascular ultrasound,renal function test,urine microalbumine excretion rate,the physical check-up for the extremities inferior and fundus inspect were 83.0%,22.1%,27.9%,94.9%,33.0%,23.9% and 8.0%,respectively.③ Comprehensive therapy and lifestyle intervention：The percents of patients who had received anti-hypertension,anti-dyslipidemia and anti-platelet therapy were 80.1%,40.6% and 29.1%,respectively.Only 6.9% of patients were given diet instruction and 0.7% were given sport therapy advice in their discharge abstracts.④ The blood glucose in 23.9% patients and hypertension in 20.8% patients were well-controlled on discharge.Conclusion It is urgent to improve the quality of the DM management in these hospitals,and more efforts need to be made to improve the quality control of diabetes prevention and treatment.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第1期62-64,共3页
Shanghai Medical Journal
关键词
糖尿病管理
住院患者
达标治疗
血糖
血脂
血压
质量控制
Diabetes management
Hospitalized patients
Blood glucose
Control to target
Blood pressure
Blood lipid profile
Quality control
