社区护士主导的健康管理模式对胰岛素治疗的糖尿病患者的效果探讨

Discussion of the effect of the health management mode led by the community nurses on the diabetic patients with insulin treatment

目的 :探讨社区护士主导的健康管理模式对接受胰岛素治疗的糖尿病患者的效果。方法 :选取2015年6月至2016年6月在长宁区周家桥街道社区卫生服务中心进行胰岛素治疗的糖尿病患者104例,随机分为试验组52例和对照组52例。试验组患者由社区护士实施慢病管理,对照组沿用全科医生门诊随访形式。结果 :1年后试验组患者的胰岛素注射操作不正确率比对照组有明显下降(P<0.05),餐后血糖和糖化血红蛋白比干预前都有明显下降[餐后血糖(10.98±3.31)mmol/L比(9.24±1.89)mmol/L,P<0.05;糖化血红蛋白(7.66±1.61)%比(7.04±0.74)%,P<0.05],对照组患者干预前后差异无统计学意义(P>0.05)。结论 :社区护士主导的健康管理模式可以降低糖尿病患者胰岛素注射操作不正确行为的发生,从而提高糖尿病患者的血糖控制水平。

Objective： To explore the effect of the health management mode led by the community nurses on the diabetic patients with insulin treatment. Methods： From June 2015 to June 2016, 104 patients with diabetes mellitus treated with insulin in Zhoujiaqiao Community Health Service Center of Changning District were selected and randomly divided into an experimental group with 52 cases and a control group with 52 ones. The chronic diseases of the patients in the experimental group were managed by the community nurses, and the patients in the control group were followed up by general practitioners. Results： After one year, the incorrect rate of insulin injection operation in the experimental group was significantly lower than that in the control group （P = 0.05）, postprandial blood glucose and HbAlc were decreased significantly than those before intervention, [postprandial blood glucose was （10.98±3.31） mmol/L to （9.24±1.89） mmol/L, P〈0.05, and HbAlc was （7.66±1.61） % to （7.04±0.74） %, P〈0.05]. The control group showed no significant difference before and after intervention （P 〉 0.05）. Conclusion： Health management mode led by the community nurses can reduce the incidence of incorrect insulin injection in the diabetic patients so as to improve the level of blood glucose control in diabetic patients.