摘要
目的探讨社区强化管理对2型糖尿病患者的管理效果。方法选取2011年1—2月到本中心就诊的2型糖尿病患者289例作为本研究对象,采用计算机产生的随机数字表将289例患者随机分为强化管理组141例和一般管理组148例。一般管理组采用传统社区管理模式;强化管理组在此基础上给予建立完善健康档案、举办糖尿病健康教育讲座、建立量化随访档案等强化管理模式。干预随访两年后,比较两组患者的血糖、血脂等各项指标及随访期间糖尿病酮症酸中毒、糖尿病肾病、糖尿病足、冠心病、糖尿病视网膜病变等并发症发生风险有无差别。结果共有272例入组患者完成随访,17例失访,失访率为5.9%。管理前,两组患者体质指数、血糖、血脂等各项指标比较,差异无统计学意义(P>0.05);随访两年后,强化管理组的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于一般管理组,差异均有统计学意义(P<0.05)。随访期间,强化管理组发生糖尿病相关并发症12例,一般管理组发生24例,强化管理组随访两年内发生糖尿病并发症的风险低于一般管理组(HR=0.68,P=0.04)。结论社区强化管理对2型糖尿病患者血糖控制有明显的优势,可显著降低患者糖尿病并发症的发生率。
Objective To evaluate the clinical efficacy of community strengthen management on type 2 diabetes melli-tus.Methods 289 subjects with type 2 diabetes visiting in our center from Jan 2011 to Feb 2011 were selected as the study sub-jects, who were randomly divided into strengthen management group （ treatment group ） with 141 subjects and general manage group （ control group ） with 148 subjects.The control group was adopted the traditional community manage model , while besides that, the treatment group was taken the community strengthened administration pattern such as setting complete health records , giving health education lectures , setting quantified follow-up files and so on.And after two -year follow -up, the two groups were compared on blood glucose , blood lipid and the risks of the occurrence of many complications such as diabetic ketoacidosis , diabetic nephropathy , diabetic foot , diabetic foot , and diabetic retinopathy during the follow -up.Results 272 subjects finally finished the treatment with 17 out of followed and lost of follow up rate was 5.9% （17/289） .Before the management , there was no statistical difference on body mass index , blood glucose and blood lipid between the two groups （ P〉0.05 ） .After two years of follow-up, the mean fasting plasma glucose and 2 hours after meal plasma glucose in the treatment group was much lower than that in the control group and the difference was significant （P〈0.05） .During the 2-year follow-up, 12 and 24 diabetes-re-lated complications were observed in the treatment group and control group , respectively.And this demonstrated that patients with type 2 diabetes receiving strength management in the community suffered lower risk of development of diabetes -related complica-tions （ HR =0.68 , P=0.04 ） .Conclusion Significant advantages of community strengthen management for type 2 diabetes were found in this study , which could significantly reduce the incidence of diabetic complications.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第10期1161-1163,共3页
Chinese General Practice
关键词
糖尿病
2型
慢病管理
糖尿病并发症
效果评价
Diabetes mellitus,type 2
Chronic disease management
Diabetes complications
Effect evaluation
