CAJ | 학술논문

目的探讨综合强化管理与医疗方法的运用对糖尿病足高危患者保肢及生活质量提高的意义.方法入选的糖尿病患者在糖尿病教育中心接受专科糖尿病教员的教育,包括常规糖尿病教育及足部特别教育,教育前后各完成糖尿病知识问卷,到达研究终点时评价强化管理组 (n=65)及普通管理组 (n=58),两组患者糖尿病知识、足部防护知识、血糖控制情况、足部溃疡发生率、截肢率的差异.结果两组的糖尿病一般知识和足部防护知识在干预前和干预后 1月无显著性差异 (P >0.05),而干预后 1年和 2年的差异则具有显著统计学意义 (P< 0.001).强化管理组在 HBA1c[(7.1± 2.3)% ]、平均收缩压 [(142± 10) mmHg〗、平均舒张压 [(80± 10)mmHg]、总胆固醇 [(4.4± 1.1)mmol/L]、三酰甘油 [(1.8± 0.9)mmol/L]的改善较普通管理组 [分别为( 8.5± 4.2)%,( 158± 9) mmHg, (92± 10)mmHg, (5.6± 2.6)mmol/L, (2.5± 1.8)mmol/L]显著 (t=2.310,9.019,6.647,2.804,2.745,P< 0.05),强化管理组的糖尿病足发生率 (7.7% )及截肢率( 3.1%)较普通管理组( 20.7%, 13.8%)显著降低 (t=4.347,4.712,P< 0.05).结论强化管理有助于减少糖尿病足发生率及截肢率,提高生活质量及节省医疗费用.
목적탐토종합강화관리여의료방법적운용대당뇨병족고위환자보지급생활질량제고적의의.방법입선적당뇨병환자재당뇨병교육중심접수전과당뇨병교원적교육,포괄상규당뇨병교육급족부특별교육,교육전후각완성당뇨병지식문권,도체연구종점시평개강화관리조 (n=65)급보통관리조 (n=58),량조환자당뇨병지식、족부방호지식、혈당공제정황、족부궤양발생솔、절지솔적차이.결과량조적당뇨병일반지식화족부방호지식재간예전화간예후 1월무현저성차이 (P >0.05),이간예후 1년화 2년적차이칙구유현저통계학의의 (P< 0.001).강화관리조재 HBA1c[(7.1± 2.3)% ]、평균수축압 [(142± 10) mmHg〗、평균서장압 [(80± 10)mmHg]、총담고순 [(4.4± 1.1)mmol/L]、삼선감유 [(1.8± 0.9)mmol/L]적개선교보통관리조 [분별위( 8.5± 4.2)%,( 158± 9) mmHg, (92± 10)mmHg, (5.6± 2.6)mmol/L, (2.5± 1.8)mmol/L]현저 (t=2.310,9.019,6.647,2.804,2.745,P< 0.05),강화관리조적당뇨병족발생솔 (7.7% )급절지솔( 3.1%)교보통관리조( 20.7%, 13.8%)현저강저 (t=4.347,4.712,P< 0.05).결론강화관리유조우감소당뇨병족발생솔급절지솔,제고생활질량급절성의료비용.
Aim To evaluate the efficacy of the comprehensive reinforcing management and medical therapy to reduce amputation incidence and promote quality of life in diabetic patients at high risk for diabetic foot(DF).Methods 123 diabetic patients at high risk for diabetic foot were employed to participate in a 2-year prospective study.All of them received a routine education and foot care program for type 2 diabetes in Diabetic Care Center, and were randomly divided into two sex and age-matched groups: reinforcing management group(n=65,group A) and standard management group(n=58, group B).Diabetic education questionnaire were conducted in all the patients before and after education. At the end of the investigation, the differences between group A and group B were evaluated in the diabetic knowledge, foot care knowledge, blood sugar control and incidence of diabetic foot ulcer and amputation. Results There was an insignificant difference between the general and foot care knowledge of the group A and B before and after 1 month intervention (P >0.05), but a significant difference between the two groups after 1- 2 year intervention(P< 0.001).The concentration of HBA1c in the group A was (7.1± 2.3)% , significantly lower than that of the group B [(8.5± 4.2)% ,t=2.310,P< 0.05]. The average systolic pressure and diastolic pressure of the group A were ( 142± 10) mmHg and (80± 10)mmHg respectively, significantly lower than those of the group B [(158± 9) mmHg and (92± 10)mmHg respectively,t=9.019, 6.647,P< 0.05].The concentrations of total cholesterol and triacylglycerol in the group A were(4.4± 1.1)mmol/L and (1.8± 0.9)mmol/L respectively, significantly lower than those in the group B (5.6± 2.6)mmol/L and (2.5± 1.8)mmol/L respectively,t=2.804, 2.745,P< 0.05]. The DF incidence and amputated rate of the group A were 7.7% and 3.1% respectively, significantly lower than those of the group B(20.7% and 13.8% respectively, t=4.347,4.712,P< 0.05). Conclusion The reinforcing management was beneficial to reduce the incidence of diabetic foot and amputation, and meanwhile to promote the quality of life and save medical cost.