全科-专科联合模式管理社区2型糖尿病患者的效果评价

Evaluation of the effect of the general practice-specialist joint mode in the management of patients with type 2 diabetes in the community

目的:探索全科-专科联合模式管理社区2型糖尿病患者的效果。方法:选取2017年2月19日至2018年2月19日已在上海南翔镇社区卫生服务中心签约的2型糖尿病患者128例,按实施奇偶数法分为观察组和对照组各64例,观察组中男性33例,女性31例,平均年龄(71.08±3.26)岁,平均病程(11.29±2.39)年;对照组中男性34例,女性30例;平均年龄(71.56±3.48)岁,平均病程(11.51±2.47)年。对对照组患者用传统管理模式,对观察组患者实施全科-专科联合管理模式进行为期1年的随访与管理。结果:1年后,观察组饮食控制(96.88%)、遵医服药(98.44%)、自我监测(98.44%)、并发症预防(93.75%)均优于对照组,差异有统计学意义(P<0.05),2型糖尿病患者空腹血糖、餐后2 h血糖、糖化血红蛋白的平均水平均低于对照组,差异有统计学意义(P<0.05)。观察组的舒张压、收缩压改善情况优于对照组,差异有统计学意义(P<0.05)。结论:全科-专科联合模式下的2型糖尿病患者管理能够有效提高全科和专科医生的诊治效率、缓解患者的病情,降低患者发生并发症的风险,改善患者的生活质量。

Objective:To explore the effect of the general practice-specialist joint mode in managing patients with type 2 diabetes in the community.Methods:From February 19,2017 to February 19,2018,128 patients with type 2 diabetes who had signed a contract with Nanxiang Community Health Service Center in Shanghai were selected,and according to the odd even method divided into an observation group and a control group with 64 cases each.In the observation group,there were 33 males and 31 females with an average age of(71.08±3.26)years and an average course of disease was(11.29±2.39)years;in the control group,there were 34 males and 30 females with an average age of(71.56±3.48)years and an average course of disease was(11.51±2.47)years.The patients in the control group were treated with traditional management mode,and the patients in the observation group were followed up and managed for a period of 1 year by implementing the general practice-specialist management mode.Results:After 1 year,the diet control(96.88%),medication compliance(98.44%),selfmonitoring(98.44%)and complication prevention(93.75%)in the observation group were superior to those in the control group,and the differences were statistically significant(P<0.05).The average levels of fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin in patients with type 2 diabetes in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The improvement of diastolic and systolic blood pressures in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The management of type 2 diabetes patients under the general practice-specialist mode can effectively improve the diagnosis and treatment efficiency of general practitioners and specialists,alleviate the patient’s condition,reduce the risk of complications,and improve the life quality of the patients.