CAJ | 학술논문

目的：探讨实施社区卫生服务属地管理对糖尿病患者依从性的影响。方法2009年1月～2012年12月本研究采取随机整群抽取的方法随机抽取我市某4个社区，对该社区常住居民采用社区卫生服务属地管理模式。随访属地管理前、属地管理后社区居民及糖尿病患者的相关情况。结果属地管理前后社区居民糖尿病患病率接近（12.35% vs 11.29%，P＞0.05）。属地管理后社区居民高血压、糖尿病知识知晓率明显高于属地管理前，差异具有统计学意义（P＜0.001）。属地管理后社区居民定期测血压、定期测血糖、低糖饮食及规律运动等健康行为的人数比例明显高于属地管理前，差异有计学意义（P＜0.001）。而吸烟、饮酒及高脂饮食等不良行为的比例明显低于属地管理前，差异有统计学意义（P＜0.001）。属地管理后患者依从性、合理用药率及疾病控制率均明显好于属地管理前，差异有统计学意义（均P＜0.001）。属地管理后糖尿病患者并发症、残疾率及病死率明显低于属地管理前，差异有统计学意义（均P＜0.001）。结论慢性病的防控有赖于政府、社会、居民及家庭的一起努力，而实施社区卫生服务属地管理是慢性病防控的一条有效途径。
목적：탐토실시사구위생복무속지관리대당뇨병환자의종성적영향。방법2009년1월～2012년12월본연구채취수궤정군추취적방법수궤추취아시모4개사구，대해사구상주거민채용사구위생복무속지관리모식。수방속지관리전、속지관리후사구거민급당뇨병환자적상관정황。결과속지관리전후사구거민당뇨병환병솔접근（12.35% vs 11.29%，P＞0.05）。속지관리후사구거민고혈압、당뇨병지식지효솔명현고우속지관리전，차이구유통계학의의（P＜0.001）。속지관리후사구거민정기측혈압、정기측혈당、저당음식급규률운동등건강행위적인수비례명현고우속지관리전，차이유계학의의（P＜0.001）。이흡연、음주급고지음식등불량행위적비례명현저우속지관리전，차이유통계학의의（P＜0.001）。속지관리후환자의종성、합리용약솔급질병공제솔균명현호우속지관리전，차이유통계학의의（균P＜0.001）。속지관리후당뇨병환자병발증、잔질솔급병사솔명현저우속지관리전，차이유통계학의의（균P＜0.001）。결론만성병적방공유뢰우정부、사회、거민급가정적일기노력，이실시사구위생복무속지관리시만성병방공적일조유효도경。
Objective To study the influence of implementation of apanage management of community health service on compliance of patients with diabetes.Methods 4 communities in our city during 2009.1 and 2012.12 were randomly selected by random cluster sampling method. Community residents were applied with apanage management of community health service. Status of community residents and patients with diabetes was followed up before apanage management and after apanage management.Results Prevalence rate of diabetes of community residents was similar before and after apanage management(12.35% vs 11.29%,P>0.05). After apanage management aware of knowledge about hypertension, diabetes of community residents, were significantly higher than before, and there were significant difference(P<0.001). Proportion of health behavior such as regular blood pressure measurement, measuring blood sugar, low sugar diet and regular exercise on a regular basis after apanage management in community residents was obviously higher than that of before apanage management, with significant difference(P<0.001). And the proportion of bad behavior such as smoking, alcohol consumption and a high-fat diet, were significantly lower than before, with significant difference(P<0.001). After apanage management, compliance, rational use of drugs and disease control rates of patients were significantly better than that of before apanage management, with significant difference(allP<0.001). Diabetes complications, disability and mortality after apanage management in patients were significantly lower than before apanage management, and there were significant difference(allP<0.001).Conclusion Chronic diseases' prevention and control depends on the working together of government, society, residents and families, and implementation of apanage management of community health service is an effective way of prevention and control of chronic diseases.