三级联合防治管理对2型糖尿病患者的管理效果分析

Three-tier integrated model for management of type 2 diabetic patients

对2015年1月1日至3月1日期间在青岛市市南区医院就诊、行社区-二级-三级医院联合防治管理（三级联合防治管理）1年的106例糖尿病患者的临床资料,进行回顾分析,并与106例未行三级联合防治管理患者（对照组）比较.管理12个月后,观察组患者的血糖[空腹血糖（6.8±2.3）比（8.7±2.8） mmol/L,餐后血糖（8.9±1.9）比（11.9±2.9） mmol/L]、血脂、糖化血红蛋白[（6.9±1.2）％比（7.8±1.5）％]等指标较对照组明显降低（均P〈0.05）;胰岛功能[稳态模型胰岛β细胞功能（2.87±0.57）比（2.24±0.35）]、自我管理能力[（19.9±4.5）比（11.9±3.0）分]及血糖控制达标率（64.2％比16.0％）较对照组明显升高（均P〈0.05）;观察组与对照组并发症发生率分别为34.0％、44.3％,转诊率分别为46.2％、19.8％.提示三级联合防治管理对2型糖尿病患者的血糖、血脂等指标的控制、胰岛功能、自我管理能力及血糖控制达标率的提高有促进作用,有利于预防并减少糖尿病并发症的发生.

Two hundred and twelve type 2 diabetes mellitus （T2DM） patients were followed up for 1 years,they were divided randomly into the control group and the study group （n =106 for each）.Patients in study group were managed by a community-secondary hospital-tertiary hospital integrated system.The blood glucose,lipids,islet function,glucose control rate,self-management ability,diabetic complications,and referral rate were compared between two groups.The levels of blood glucose,lipid,blood pressure and glycosylated hemoglobin in study group were significantly lower than those in control group （P 〈 0.05）.The islet function,self-management ability and blood glucose control rate in study group were significantly higher than those of in control group after the management （P 〈 0.05）.During the 12-month follow-up the incidence rates of complications in study group and control group were 34.0%,44.3%;and referral rates were 46.2%,19.8%,respectively.The integrated management system is beneficial to T2DM patients with improving the control rate of blood glucose,enhancing the ability of self-management,and reducing the incidence of diabetic complications.