中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
10期
1161-1163
,共3页
糖尿病,2型%慢病管理%糖尿病并发症%效果评价
糖尿病,2型%慢病管理%糖尿病併髮癥%效果評價
당뇨병,2형%만병관리%당뇨병병발증%효과평개
Diabetes mellitus,type 2%Chronic disease management%Diabetes complications%Effect evaluation
目的：探讨社区强化管理对2型糖尿病患者的管理效果。方法选取2011年1-2月到本中心就诊的2型糖尿病患者289例作为本研究对象，采用计算机产生的随机数字表将289例患者随机分为强化管理组141例和一般管理组148例。一般管理组采用传统社区管理模式；强化管理组在此基础上给予建立完善健康档案、举办糖尿病健康教育讲座、建立量化随访档案等强化管理模式。干预随访两年后，比较两组患者的血糖、血脂等各项指标及随访期间糖尿病酮症酸中毒、糖尿病肾病、糖尿病足、冠心病、糖尿病视网膜病变等并发症发生风险有无差别。结果共有272例入组患者完成随访，17例失访，失访率为5.9％。管理前，两组患者体质指数、血糖、血脂等各项指标比较，差异无统计学意义（P＞0.05）；随访两年后，强化管理组的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于一般管理组，差异均有统计学意义（ P＜0.05）。随访期间，强化管理组发生糖尿病相关并发症12例，一般管理组发生24例，强化管理组随访两年内发生糖尿病并发症的风险低于一般管理组（ HR ＝0.68， P＝0.04）。结论社区强化管理对2型糖尿病患者血糖控制有明显的优势，可显著降低患者糖尿病并发症的发生率。
目的：探討社區彊化管理對2型糖尿病患者的管理效果。方法選取2011年1-2月到本中心就診的2型糖尿病患者289例作為本研究對象，採用計算機產生的隨機數字錶將289例患者隨機分為彊化管理組141例和一般管理組148例。一般管理組採用傳統社區管理模式；彊化管理組在此基礎上給予建立完善健康檔案、舉辦糖尿病健康教育講座、建立量化隨訪檔案等彊化管理模式。榦預隨訪兩年後，比較兩組患者的血糖、血脂等各項指標及隨訪期間糖尿病酮癥痠中毒、糖尿病腎病、糖尿病足、冠心病、糖尿病視網膜病變等併髮癥髮生風險有無差彆。結果共有272例入組患者完成隨訪，17例失訪，失訪率為5.9％。管理前，兩組患者體質指數、血糖、血脂等各項指標比較，差異無統計學意義（P＞0.05）；隨訪兩年後，彊化管理組的空腹血糖、餐後2 h血糖、糖化血紅蛋白水平均低于一般管理組，差異均有統計學意義（ P＜0.05）。隨訪期間，彊化管理組髮生糖尿病相關併髮癥12例，一般管理組髮生24例，彊化管理組隨訪兩年內髮生糖尿病併髮癥的風險低于一般管理組（ HR ＝0.68， P＝0.04）。結論社區彊化管理對2型糖尿病患者血糖控製有明顯的優勢，可顯著降低患者糖尿病併髮癥的髮生率。
목적：탐토사구강화관리대2형당뇨병환자적관리효과。방법선취2011년1-2월도본중심취진적2형당뇨병환자289례작위본연구대상，채용계산궤산생적수궤수자표장289례환자수궤분위강화관리조141례화일반관리조148례。일반관리조채용전통사구관리모식；강화관리조재차기출상급여건립완선건강당안、거판당뇨병건강교육강좌、건립양화수방당안등강화관리모식。간예수방량년후，비교량조환자적혈당、혈지등각항지표급수방기간당뇨병동증산중독、당뇨병신병、당뇨병족、관심병、당뇨병시망막병변등병발증발생풍험유무차별。결과공유272례입조환자완성수방，17례실방，실방솔위5.9％。관리전，량조환자체질지수、혈당、혈지등각항지표비교，차이무통계학의의（P＞0.05）；수방량년후，강화관리조적공복혈당、찬후2 h혈당、당화혈홍단백수평균저우일반관리조，차이균유통계학의의（ P＜0.05）。수방기간，강화관리조발생당뇨병상관병발증12례，일반관리조발생24례，강화관리조수방량년내발생당뇨병병발증적풍험저우일반관리조（ HR ＝0.68， P＝0.04）。결론사구강화관리대2형당뇨병환자혈당공제유명현적우세，가현저강저환자당뇨병병발증적발생솔。
Objective To evaluate the clinical efficacy of community strengthen management on type 2 diabetes melli-tus.Methods 289 subjects with type 2 diabetes visiting in our center from Jan 2011 to Feb 2011 were selected as the study sub-jects, who were randomly divided into strengthen management group ( treatment group ) with 141 subjects and general manage group ( control group ) with 148 subjects.The control group was adopted the traditional community manage model , while besides that, the treatment group was taken the community strengthened administration pattern such as setting complete health records , giving health education lectures , setting quantified follow-up files and so on.And after two -year follow -up, the two groups were compared on blood glucose , blood lipid and the risks of the occurrence of many complications such as diabetic ketoacidosis , diabetic nephropathy , diabetic foot , diabetic foot , and diabetic retinopathy during the follow -up.Results 272 subjects finally finished the treatment with 17 out of followed and lost of follow up rate was 5.9% (17/289) .Before the management , there was no statistical difference on body mass index , blood glucose and blood lipid between the two groups ( P>0.05 ) .After two years of follow-up, the mean fasting plasma glucose and 2 hours after meal plasma glucose in the treatment group was much lower than that in the control group and the difference was significant (P<0.05) .During the 2-year follow-up, 12 and 24 diabetes-re-lated complications were observed in the treatment group and control group , respectively.And this demonstrated that patients with type 2 diabetes receiving strength management in the community suffered lower risk of development of diabetes -related complica-tions ( HR =0.68 , P=0.04 ) .Conclusion Significant advantages of community strengthen management for type 2 diabetes were found in this study , which could significantly reduce the incidence of diabetic complications.
