互动式信息化医疗服务在糖尿病防治中的临床价值

Clinical values of medical service by Internet communication in the treatment and prevention of diabetes mellitus

目的:探索让病人如何参与糖尿病防治,研究糖尿病患者的生活质量、满意度、医疗费用、就诊费用等经医院网站新型医疗服务模式。方法:选择40例年龄29～56岁,不定期上网的糖尿病患者为研究组,定期组织病人进行检查,制定最初治疗方案。病人或(及)家属随时在线与糖尿病专家联系,并与非上网治疗的糖尿病患者(对照组)比较。两组病人每月检查空腹血糖、餐后2h血糖、胆固醇、甘油三酯、血压,3个月对病人考核1次,包括糖尿病知识、生活质量、心理评估(症状自评量表SCL-90和世界卫生组织生活质量量表中文版WHOQOL-100)、服务满意度评分,并测定以上指标和糖化血红蛋白、体质指数,统计降糖药物剂量、医疗费用和就诊费用等,时间6个月。结果:两组患者治疗后血糖、血压和血脂均明显改善,治疗前后两组相比差异无显著性。治疗前后糖尿病知识和就诊费用及SCL-90躯体化、焦虑、恐怖、抑郁两组相比有显著统计学差别(P<0.001),研究组病人的总体生活质量、总体心理健康水平和医疗服务满意度优于对照组(P<0.05)。结论:通过互联网医生对患者作糖尿病健康和心理健康教育和防治,医生像在诊室、病人像在家一样,具有让病人心理健康、疗效满意、方便省时、省钱便捷等优点。

Objective To investigate a novel mode of medical service by the Internet to provide education on the treatment and prevention of diabetes mellitus and to study diabetic patient＇s quality of life, medical costs, and satisfaction with medical service. Methods 40 diabetics who could use the Internet were recruited to this study. They received regular examination and primary therapy scheme, and then communicated with diabetic specialists online. FBG, 2hPG, TC, TG, and BP were measured monthly in these patients and the control diabetics who were not Internet users. All patients were assessed for their knowledge of diabetes, quality of life, psychological status, and satisfaction with service every 3 months. HbAlc, BMI, sum of hypoglycemic agents, medical costs were determined at the sixth month. Results Blood glucose, lipids, and pressure were significantly improved after treatment in both groups and there was no significant difference. But knowledge of diabetes, medical costs, and psychological assessment scores differed significantly between two groups （P 〈 0.001 ）. Quality of life and satisfaction with service in the experimental group were superior to those in the control group. Conclusion Internet communication between the physicians and patients is of beneficial in instructing the management of diabetes and reducing medical costs and achieves ideal effectiveness.