社区与三甲医院联合标准化管理对2型糖尿病患者代谢指标的影响

The Influence of the Standardized Management of the Community and the Top Three Hospitals on the Metabolic Indexes of Type 2 Diabetic Patients

目的探讨厦门市思明区开元街道社区卫生服务中心与三甲医院联合标准化管理模式对2型糖尿病患者代谢指标的影响。方法于2016年11月—2017年10月对厦门市开元社区409例血糖不达标的2型糖尿病患者进行了为期24个月的治疗和随访。结果研究对象在标准化管理后糖化血红蛋白、低密度脂蛋白胆固醇、收缩压、舒张压的达标率分别为29.0%、45.4%、76.3%、94.2%,均较管理前(0.0%、31.7%、58.8%、83.4%)明显提高,差异有统计学意义(P<0.001);血糖、血脂、血压三者的联合达标率也明显高于管理前(12.9%vs 0.0%),差异有统计学意义(P<0.001)。结论社区卫生服务中心与三甲医院联合标准化管理模式可有效提高2型糖尿病患者血糖、血脂、血压及三者联合达标率,对糖尿病整体防治水平的提高有重要意义。

Objective To investigate the effect of the joint standardized management model of Kaiyuan Street Community Health Service Center and Class-A hospitals in Siming District,Xiamen City on the metabolic indexes of patients with type 2 diabetes.Methods From November 2016 to October 2017,409 patients with type 2 diabetes with substandard blood sugar in Kaiyuan Community of Xiamen were treated and followed up for 24 months.Results After standardized management,the compliance rates of glycosylated hemoglobin,low-density lipoprotein cholesterol,systolic blood pressure,and diastolic blood pressure were 29.0%,45.4%,76.3%,and 94.2%,respectively,which were higher than those before management(0.0%,31.7%,58.8%,83.4%),the difference was statistically significant(P<0.001);the combined compliance rate of blood glucose,blood lipid,and blood pressure was also significantly higher than before management(12.9%vs 0.0%),the difference was statistically significant(P<0.001).Conclusion The combined standardized management model of community health service centers and tertiary hospitals can effectively improve the blood glucose,blood lipid,blood pressure and the combined compliance rate of type 2 diabetes patients,which is of great significance to the improvement of the overall level of diabetes prevention and treatment.