糖尿病患者运动前测试与评估临床路径构建的经验启示与实现框架

Experience,Inspiration,and Implementation Framework of Pre-exercise Testing and Evaluation Clinical Pathway Construction for Diabetic Patients

运动是防治糖尿病的重要手段,但运动在带来显著健康效益的同时,也伴随有运动损伤、心源性猝死等的发生风险。作为运动处方制定的第一步,运动前测试与评估可通过筛选出患有运动禁忌证、需要医疗许可或医务监督的患者,以减少运动不良事件的发生。目前,针对糖尿病患者的运动前测试与评估体系存在内容不完整、路径待规范等现实问题,构建规范操作体系有利于提高患者运动的安全性。参照临床路径构建方法,以卫生技术评估为目标导向,提出糖尿病患者运动前测试与评估临床路径构建的原则和内容。以建立操作流程为例,运用德尔菲法开展糖尿病患者运动前测试与评估临床路径构建的初步探索。

As an important cornerstone of prevention and treatment for diabetes,exercise benefits to people's health,at the same time risks exist.Exercise can cause various adverse events,such as sports injury and sudden cardiac death.Being the first step of exercise prescription,pre-exercise testing and evaluation can reduce the incidence of adverse events by screening patients with exercise contraindications and requiring medical clearance or medical supervision.However,the recommendations on pre-exercise testing and evaluation for diabetes are not complete and standardized.Constructing the standardized content and process of pre-exercise testing and evaluation for diabetic patients will improve the safety for exercise.Based on health technology assessment,principles and contents are proposed in terms of the construction of clinical pathway of pre-exercise testing and evaluation for diabetic patients.Finally,taking the construction of operating procedure as an example,an empirical study was carried out based on Delphi.