社区糖尿病视网膜病变综合干预效果分析

Analysis of Comprehensive Intervention Effect on Diabetics' Retinopathy in Community

目的 :评价社区综合干预对糖尿病视网膜病变患者管理的效果。方法:选择2015年3月~2017年4月纳入石河子6、7社区糖尿病慢性管理档案的2型糖尿病病人465例,进行问卷调查,并行常规糖尿病(diabetes mellitus,DM)管理及2年的系统综合干预。观察患者干预前后对糖尿病性视网膜病变认知度变化、眼底、空腹血糖及糖化血红蛋白情况,并进行比较分析。结果:干预结束,干预后患者对于糖尿病视网膜病变(diabetic retinopathy,DR)的认知度较前明显提高,差异具有统计学意义(P<0.0001);干预后空腹血糖、餐后2小时血糖、糖化血红蛋白均较干预前明显改善,差异具有统计学意义(t值0.807,P<0.0001;t值0.611,P<0.0001;t值0.917,P<0.0001);干预后糖尿病视网膜病变早期诊断率达100%;糖尿病视网膜病变较干预前未见明显进展,差异有统计学意义(χ2=4.64,P<0.0001)。结论:实行以社区为基础的糖尿病视网膜病变患者综合干预,可以明显提高患者对DR认知度,有效控制患者的血糖水平,提高早期诊断率,缓解病情发展。

Objective： To evaluate the effect of community comprehensive intervention on patients withdiabetic retinopathy.Methods：465 patients with type 2 diabetes mellitus which were in chronic diabetes mellitusmanagement of 6 and7 community in shihezi from March 2015 to April 2017 were selected.Questionnaire, diabetesmellitus management, and two years＇ systematic comprehensive intervention were carried out.The changes of diabeticretinopathy cognition, fundus, fasting blood glucose and glycosylated hemoglobin before and after intervention wereobserved and comparative analyzed.Results： The patients＇ cognition of diabetic retinopathy （DR） was significantlyimproved after intervention, and the difference was statistically significant（P〈0.0001）.Fasting blood glucose, bloodglucose and glycosylated hemoglobin were significantly improved after the intervention, and the difference wasstatistically significant（P=0.807,P 〈0.0001;T=0.611, P〈0.0001; T=0.917,P〈0.0001）.The early diagnosis rate ofdiabetic retinopathy was 100%.Diabetic retinopathy didn＇t have obvious progress compared with before.The differencewas statistically significant（X^2=4.64, P〈0.0001）.Conclusion：The community-based comprehensive intervention inpatients with diabetic retinopathy can significantly improve patients＇ DR awareness, effective control of the patients＇blood sugar level, improve the early diagnostic rate, alleviate illness development.