综合干预对儿童糖尿病的临床效果研究

Clinical effect of comprehensive intervention on diabetes in children

目的探讨儿童糖尿病综合干预的临床效果和可行性。方法选取2008年5月-2010年6月新发糖尿病50例(对照组-未进行综合干预)、2013年5月-2015年6月新发糖尿病100例(观察组-进行综合干预),随诊观察3年,比较2组随访3年后患儿糖化血红蛋白(HbA1c)均值,及3年中严重低血糖发生率、糖尿病酮症酸中毒(DKA)发生率,并进行统计学分析;将对照组患儿召回进行综合干预治疗3年(召回组),比较对照组干预治疗前后患儿HbA1c均值、3年中严重低血糖发生率及DKA发生率,进行统计学分析。结果对照组50例,男26例,女24例,年龄3.6-13.2岁,平均年龄(8.68±2.98)岁,新入院时患儿HbA1c均值(6.82±0.86)%;观察组100例,男50例,女50例,年龄3.5-13.8岁,平均年龄(8.11±3.0)岁,新入院时患儿HbA1c均值(6.88±0.90)%;2组年龄、HbA1c、DKA发生率比较差异均无统计学意义(P>0.05)。2组治疗3年后,观察组91例(失访9例),HbA1c均值(7.3±1.51)%、严重低血糖发生率20.9%、DKA发生率16.5%;对照组45例(失访5例)HbA1c均值(10.4±1.98)%、严重低血糖发生率46.7%、DKA40.0%;两组比较,差异有统计学意义(P<0.05)。召回组31例患儿综合干预治疗,干预治疗前HbA1c均值(10.78±2.06)%,严重低血糖发生率48.4%,DKA发生率43.3%;干预治疗后HbA1c均值(9.78±1.79)%,严重低血糖发生率16.1%,DKA发生率12.9%;进行比较,差异有统计学意义(P<0.05)。结论综合干预治疗对儿童糖尿病的血糖控制、降低并发症发生临床效果显著。

Objective To explore the clinical effect and feasibility of comprehensive intervention for children with diabetes.Methods 50 cases of newly-onset diabetes(control group-without comprehensive intervention)from May 2008 to June 2010,and100 cases of newly-onset diabetes(observation group-comprehensive intervention)from May 2013 to June 2015 were selected.After 3 years of follow-up,the mean values of glycated hemoglobin(HbA1 c),the incidence of severe hypoglycemia,and the incidence of diabetic ketoacidosis(DKA)in the two groups were compared after 3 years of follow-up.Statistical analysis was performed;Children in the group were recalled for comprehensive intervention treatment for 3 years(recall group),and the mean HbA1 c,the incidence of severe hypoglycemia,and the incidence of DKA in the control group were compared before and after intervention in the control group for statistical analysis.Results There were 50 patients in the control group,26 males and 24 females,aged 3.6-13.2 years,with an average age of(8.68±2.98)years.The mean HbA1 c of the children at the time of new admission was(6.82±0.86)%;100 patients in the observation group,50 males,and 50 females,the age was 3.5-13.8 years,the average age was(8.11±3.0)years,and the mean HbA1 c was(6.88±0.90)%when the children were newly admitted.There was no significant difference in the age,HbA1 c,and DKA incidence between the two groups(P>0.05).After 3 years of treatment in the two groups,91 cases in the observation group(nine cases lost to follow-up),mean HbA1 c(7.3±1.51)%,incidence of severe hypoglycemia 20.9%,and incidence of DKA 16.5%;45 cases in the control group(5 cases lost to follow-up)HbA1 c The mean value was(10.4±1.98)%,the incidence of severe hypoglycemia was 46.7%,and DKA was 40.0%.The difference between the two groups was statistically significant(P<0.05).31 patients in the recall group were treated with comprehensive intervention and the mean value of HbA1 c before intervention(10.78±2.06)%,the incidence of severe hypoglycemia was 48.4%,the incidence of DKA was 43.3%;the mean HbA1 c after intervention was(9.78±1.79)%,the incidence of severe hypoglycemia was 16.1%,and the incidence of DKA was 12.9%.The difference was statistically significant.(P<0.05).Conclusion The comprehensive intervention has significant clinical effect on blood glucose control and reduction of complications in children with diabetes.