电话随访干预对糖尿病性视网膜病变术后患者并发症、血糖、自我管理能力及生活质量的影响

Effects of telephone follow-up intervention on complications, blood glucose, self-management ability and quality of life of patients with diabetic retinopathy after surgery

目的探讨电话随访干预对糖尿病性视网膜病变术后患者并发症、血糖、自我管理能力及生活质量的影响。方法选取2019年1~7月南阳市中心医院糖尿病视网膜病变行手术治疗的100例患者(148只眼),随机分为对照组(70只眼)与观察组(78只眼)两组,每组50例患者,对照组出院后由患者自行根据随访时间到院进行随访及复诊,观察组患者出院后定期进行电话随访干预,观察两组患者术后6个月内并发症发生情况、干预前和干预后6个月时的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c),采用2型糖尿病自我管理行为问卷(2-DSCS)评价患者自我管理能力及采用糖尿病特异性生活质量量表修订版评价(A-DQOL)患者术后生活质量。结果观察组患者术后继发性高眼压、新生血管、白内障、再出血、黄斑水肿及黄斑前膜等并发症发生率低于对照组,差异有统计学意义(P<0.05);两组患者干预后FPG、2 h PG、HbA1c水平明显低于干预前,差异有统计学意义(P<0.05),且观察组干预后以上指标水平明显低于对照组,差异有统计学意义(P<0.05);两组患者干预后2-DSCS量表中饮食、运动、血糖监测、足部护理、遵医嘱用药、预防及处理低血糖得分明显高于干预前,差异有统计学意义(P<0.05),且观察组干预后以上指标水平明显高于对照组,差异有统计学意义(P<0.05);两组患者干预后A-DQOL量表中影响程度、满意程度、忧虑程度Ⅰ和忧虑程度Ⅱ得分明显低于干预前,差异有统计学意义(P<0.05),且观察组干预后以上指标水平明显低于对照组,差异有统计学意义(P<0.05)。结论对糖尿病性视网膜病变术后患者出院后进行定期电话随访干预,可明显降低并发症发生率,改善血糖水平,提高自我管理能力及改善生活质量。

Objective To explore the effects of telephone follow-up intervention on complications,blood glucose,self-management ability and quality of life of patients with diabetic retinopathy.Methods A total of 100 patients(148 eyes)who received surgical treatment for diabetic retinopathy in Nanyang Central Hospital from January to July 2019 were selected and randomly divided into control group(70 eyes)and observation group(78 eyes),with 50 patients in each group.Patients in the control group were followed up and returned to the hospital according to the follow-up time after discharge,while patients in the observation group received regular telephone follow-up intervention after discharge.The incidence of complications within 6 months after surgery,fasting blood glucose(FPG),2 hours postprandial blood glucose(2 h PG)and HbA1c were observed in two groups before and 6 months after intervention.Self-management ability was evaluated by 2-DSCS and postoperative quality of life was evaluated by A-DQOL.Results The incidence of postoperative complications such as secondary ocular hypertension,neovascularization,cataract,rebleeding,macular edema and macular membrane in the observation group was lower than that in the control group,and the differences were statistically significan(P<0.05).The levels of FPG,2 h PG and HbA1c in both groups were significantly lower than those before intervention,and the differences were statistically significant(P<0.05),and the levels of above parameters in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The scores of diet,exercise,blood glucose monitoring,foot care,drug compliance and hypoglycemia in 2-DSCS in both groups were significantly higher than those before intervention,and the differences were statistically significant(P<0.05),and the levels of above indexes in the observation group were significantly higher than those in the control group,and the differences were statistically significan(P<0.05).After intervention,the scores of influence degree,satisfaction degree,worry degreeⅠand worry degreeⅡin A-DQOL scale of patients in both groups were significantly lower than those before intervention,and the differences were statistically significant(P<0.05).And the levels of above indexes in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Regular telephone follow-up intervention after discharge of patients with diabetic retinopathy after operation can significantly reduce the incidence of complications,improve the blood glucose level,the self-management ability and the quality of life.