摘要
目的通过对社区卫生服务中心转诊到区中心医院住院糖尿病患者的临床状况进行调查,分析转诊患者的临床状况,以改进糖尿病管理中存在的问题。方法对2009～2010年上海某社区卫生服务中心转诊到区中心医院内分泌科的住院糖尿病患者466例进行问卷调查。结果 466例患者中,直接转诊组138例(29.61%),间接转诊组328例(70.38%)。并发急性并发症90例(19.31%)、慢性并发症311例(66.74%),合并感染者101例(21.67%)、其他疾病者93例(19.96%),血糖控制不良需要强化治疗者330例(70.82%)。直接转诊组收缩压明显升高、低血糖症显著增多(P<0.05),而间接转诊组血清肌酐升高、周围血管病变、背景型视网膜病变显著多于直接转诊组(P<0.05)。结论某区中心医院内分泌科住院糖尿病患者多数已经出现并发症或合并感染等。提示上海市某区社区卫生院与区中心医院之间糖尿病患者的转诊亟待规范,以减少急慢性并发症以及合并症对糖尿病患者的危害。
Objective To investigate the clinical status of diabetic patients transferring from Community Health Centers to Fengxian medical center in Shanghai.Methods 466 inpatients were analyzed from Jan.2009 to Dec.2010 at Fengxian Centeral Hospital in Shanghai,including laboratory assessments of blood glucose,lipid and HbA1c,acute and chronic complications,height and body weight.Questionnaire was made on diagnosis,treatment and the advice about transferring from Community Health Center.Results 138 patients were transferred directly from Community Health Center（29.61%）,and 328 patients indirectly（70.38%）.90 cases had acute complications（19.31%）,311 cases had chronic complications（66.74%）,101 cases had infection（21.67%）,and 93 cased had other diseases（19.96%）.330（70.82%）patients had severe hyperglycemia and needed intensive insulin treatment.Directly transferred patients had higher systolic blood pressure（SBP） and hypoglycemia incidence,and indirectly transferred patients had higher serum creatine,diabetic peripheral vascular disease and retinopathy incidence（P0.05）.Conclusion Most diabetic inpatients had complications or infection in endocrinology department of Fengxian Centeral Hospital in Shanghai.It is urgent that diabetic patient transfer should be normalized between Community Health Centers and central hospital,in order to lowering the incidence and damage of acute and chronic complications in diabetic patients.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第10期975-977,共3页
Chongqing medicine
基金
上海市卫生局资助项目(2009225)
上海市奉贤区科委资助项目(奉科0908011)
关键词
糖尿病
病人转诊
管理
diabetes mellitus
patient transfer
management
