强化社区糖尿病规范化管理的模式和疗效

The Mode and Effect of Intensive Standard Community Management of Diabetes

目的探讨强化社区糖尿病规范化管理模式及疗效。方法选择经过社区规范化管理未得到满意控制的56名糖尿病患者,分为强化管理和普通管理组,进行连续3个月的管理治疗。强化组由社区专家或专科大夫进行一对一督导,增加诊疗频率和就诊时间。普通组由社区责任医生或社区卫生服务专职人员定期体检,填写糖尿病随访记录并给予指导。结果强化组空腹血糖6.92mmol/L,低于普通组8.60mmol/L;餐后2h血糖9.13mmol/L,低于普通组13.51mmol/L;糖化血红蛋白7.65%,低于普通组10.91%;强化组血糖控制良好者60.7%,高于普通组21.4%;糖化血红蛋白控制良好者28.6%,高于普通组7.1%。以上差别均有统计学意义(P<0.001)。强化组药费平均下降120元,普通组药费平均上升50元。结论强化组费用较低且病情控制较好。建议改进现行管理模式从而降低医疗费用。

Objective Discuss the ways to strengthen the mode and effect of the standard community management of the diabetes. Methods Choose 56 diabetics and divided into intensive group and common group, and the period of the treatment is three consecutive months. Results The mean value of FBG in intensive group of 6.92 mmol/L was significantly lower than normal group of 8.60 mmol/L.The mean value of 2 h PG in intensive group of 9.13 mmol/L was signifieantly lower than normal group of 13.51 mmol/L. Glycosylated hemoglobin in intensive group of 7.65% was significantly lower than normal group of 10.91%. There was 60.7% people that got a good standard blood glucose in intensive group significantly higher than the normal group of 21.4%. Glycosylated hemoglobin in intensive group of 28.6% was significantly higher than the normal group of 7. l%（P〈0.001）. The cost of drugs in intensive group decreased 120 yuan, nornlal group was not decreased but increased 50 yuan. Conclusion The intensive _group spends less but disease controlled well. Improving the existing community diabetes management can be trulv effective in reducing medical costs.