社区与三级医院对2型糖尿病患者联合诊治管理的效果评估

Assessment for Effect of Hospital-Community-Integrated Treatment and Management on Type Ⅱ Diabetes Patients

目的评估社区与三级医院联合对2型糖尿病患者诊治管理的效果。方法选取上海市某社区下的4个站点,随机分为干预组和对照组,对干预组实行全—专联合诊治管理,对照组实施社区常规诊治管理。干预1年后,比较干预前后糖尿病患者的健康行为与血糖控制达标情况。结果干预一年后,干预组患者健康知晓率由46.6%提高到74.5%,空腹血糖值(FBG)由(7.4±2.4)mmol/L下降为(7.1±1.9)mmol/L,餐后2小时血糖值(2 h PG)由(11.2±3.8)mmol/L下降为(10.2±3.3)mmol/L,餐后血糖达标率由31.8%提高到49.2%,干预前后比较差异有统计学意义。对照组患者干预前后变化不大,差异无统计学意义。结论社区与三级医院联合诊治管理模式能够改善糖尿病患者的行为,提高患者血糖控制。

OBJECTIVE To evaluate the effects of the tertiary hospital-community-integrated treatment and management of patients with type II diabetes. METHODS Four subdistricts chosen from a community of Shanghai were divided randomly into the intervention group and control group. Patients in the intervention group received the hospital-community-integrated treatment and management, while patients in the control group were given conventional community treatment and management. After one year of intervention, to compare the difference of patient＇ s health behavior and the effect of glycemic control between before and after intervention. RESULTS After one year of intervention, the health awareness of the intervention group increased from 46.6% to 74.5%, the fasting blood glucose （FBG） decreased from 7.36±2.38 mmol/L to （7.08±1.90） mmol/L, the postprandial 2h plasma glucose （2 hPG） decreased from （11.24±3.80） mmoi/L to （10.20±3.3） mmol/L and the post-prandial blood glucose control rates increased from 31.8% to 49.2%, and the difference was statistically significant. The control group changed a little, and there was no significant difference. CONCLUSION The tertiary hospitalcommunity-integrated diabetes treatment and management can improve the patient＇ s health behavior and the effect of glycemic control.