个案管理在2型糖尿病患者中的干预效果

The intervention effect of case management in patients with type 2 diabetes

目的:探讨个案管理对2型糖尿病患者血糖代谢、血脂和自我管理水平的干预效果。方法:从天津市某三级甲等医院选取住院接受治疗的2型糖尿病患者60例,随机分为观察组和对照组各30例。观察组患者接受6个月的个案管理干预、随访,对照组只进行传统的教育方式。评价指标包括空腹血糖(FPG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、糖尿病知识问卷得分、自我管理水平各项指标得分,于干预后6个月进行效果评价。结果 :干预6个月后,两组患者FPG、2hPBG、HbA1c、TC水平以及总体饮食得分、运动得分、血糖监测得分、足部护理得分、自护行为总分、糖尿病知识得分差异具有统计学意义(P<0.05);两组患者BMI、TG的水平及具体饮食得分差异无统计学意义(P>0.05)。结论:个案管理对2型糖尿病患者的血糖代谢及血脂水平有一定程度的改善,可提高其糖尿病知识水平,改善其自我管理能力。

Objective To explore the intervention effects on glucose metabolism, blood lipids and self-management level through casemanagement in patients with type 2 diabetes. Methods： 60 patients with type 2 diabetes were selected from a tertiary level hospital inTianjin which received treatment in hospital. They were randomly divided into the experimental group and the control group by randomnumber table, 30 cases each. The experimental group received case management intervention and follow-up for 6 months. While the controlgroup received education of traditional way. Fasting blood glucose （FBG）, 2h postprandial blood glucose （2hPBG）, glycosylated hemoglobin（HbAlc）, body mass index （BMI）, total cholesterol （TC）, triglyceride （TG）, score of diabetes knowledge questionnaire, indicators ofself-management were measured after the intervention. Results： There were significant differences in FBG, 2hPBG, HbAlc, TC, overalldiet, exercise, blood glucose monitoring, foot care, score of self-care behavior, score of diabetes knowledge questionnaire （P〈0.05） betweenthe two groups, while no significant difference in BMI, TG and specific diet （P〉0.05）. Conclusion： Case management could effectivelyimprove glucose metabolism and lipid levels in patients with diabetes to some degree, it also could improve their level of diabetesknowledge, to some extent, improve their ability of self-management