系统分阶段教育模式对糖尿病患者慢性并发症的影响

Effects of Systematically Education Models on Chronic Complications in Diabetic Patients

目的探讨系统分阶段教育模式对糖尿病慢性并发症的影响。方法将200例2型糖尿病患者随机分为系统分阶段教育组(简称系统教育组)100例、随机教育组50例、未教育组50例。其中系统教育组要求全程参加系统分阶段模式的糖尿病教育,随机教育组凭患者兴趣进行间断教育,未教育组不参加教育。入组前及入组后采取问卷调查的方式了解患者掌握糖尿病基本知识的程度及其心理状况;进行病史询问和必要的体格检查包括身高、体重、血压,及检测空腹血糖(FPG)、早餐后2 h血糖(PPG)、血脂、肾功能、糖化血红蛋白(HbA1c)、尿白蛋白(晨尿)、心电图、眼底检查。比较3组患者糖尿病代谢控制及并发症的发生发展情况。结果系统教育组教育3年后血糖、血脂代谢水平均得到明显改善,与其他2组相比,有极显著性差异(P<0.01);教育3年后眼部、肾脏、神经病变的并发症发生率系统教育组分别上升3%、8%、2%,与随机教育组(10%、14%、14%)、未教育组(20%、22%、12%)相比明显降低,有统计学差异(P<0.05)。结论系统分阶段糖尿病教育模式有利于糖尿病患者的代谢控制及降低糖尿病慢性并发症的发生。

Objective To explore the effects of of systematically health educatinal models on diabetic chronic complications. Methods 200 cases of type 2 diabetic patients were randomly divided into systematically educated group 100 cases, randomly educated group 50 cases and uneducated group 50 cases. Systematically educated group were required to participate in systematic diabetes education continuously. Randomly educated group received discontinuous diabetes education. Uneducated group received no education. Before and after intervention, the questionnaire scale was used to investigate about the patients＇ level of the basic diabetes mellitus knowledge and their mental status, case history was inquired and necessary physical examination including height,weight and blood pressure was performed. The level of fasting plasma glucose（FPG）,2 hours postprandial glucose（PPG）, blood lipid, renal function, glycosylated hemoglobin （ HbA1 c）, urinary albumin（morning urine）, electrocardiogram,ocular fundus examination were measured to compare the control of diabetic metabolism and the development of complications in three groups.Results After 3 years,the metabolism of blood glucose and lipid was improved obviously in systematically educated group. Compared with the other two groups, the differences were statistically significant（P〈0.01）. The indidence of ocular,renal and nervous lesions was increased by 3%, 8%,2% in systematically educated group, 10%, 14%, 14% in randomly educated group, 20%, 22% ,12% in uneducated group. The differences were statistically significant（P〈0.05）. Conclusion Systematic diabetes education is beneficial to the control of diabetic metabolism and the decrease of diabetic chronic complications. KEY WORDS. diabetes; systematically education model; complication