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家属参与的农村2型糖尿病患者社区管理模式探索 被引量:2

Family member-involved community management for patients with type 2 diabetes from rural areas of Deqing county
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摘要 目的探索建立患者家属作为家庭督导员参与的农村糖尿病患者社区管理新模式。方法建立专科医生为指导者、社区责任医生为管理者、患者家属为督促者的糖尿病管理模式。以德清县某镇成人2型糖尿病患者为研究对象,整群抽取4个村的患者为干预组,其他5个村的患者为对照组。对照组实施常规管理,干预组在常规管理基础上增加新管理模式的干预措施,研究时间持续1年。对比两组患者在干预前后空腹血糖、糖化血红蛋白等指标的变化。结果525例患者完成了研究,其中干预组267例,对照组258例。干预组患者空腹血糖(FBG)平均值从(7.58±2.24)mmol/L下降到(6.98±1.97)mmol/L(t=4.063,P=0.000),控制达标率从49.81%上升到68.16%(χ^2=18.586,P=0.000);糖化血红蛋白(HbA1C)控制达标率从46.44%上升到59.55%(χ^2=11.670,P〈0.01);HbA1C平均值从(7.21±1.57)%下降到(6.99±1.37)%(t=2.198,P=0.029);干预组HbA_(1C)的改变优于对照组(HbA1C值:t=4.226,P=0.000;达标变化:χ~2=38.900,P=0.000)。结论该管理模式有效建立了家庭支持系统,干预对病情控制效果明显,适用于农村糖尿病患者的社区管理。 Objective To explore a brand new community management model in which family members actively involved for patients with type 2 diabetes in rural areas of Deqing county. Methods Adult patients with type2 diabetes were randomly selected by clustering method from 9 villages of Deqing county and were divided into intervention group(patients from 4 villages)and control group(patients from 5 villages).Patients in control group were managed in the traditiona manner,and those in intervention group were managed through a new management model in which diabetic specialists worked as instructors,community physicians acted as manager and family members involved as supervisors for a year.Blood samples were collected prior and post intervention for the measurement of fast blood glucose(FBG)and hemoglobin A1 c(HbA_(1C)). Results A total of 525 patients were recruited into this study,including 267 in the intervention group and 258 in the control group.The mean serum FBG level and HbA_(1C)level decreased from(7.58±2.24)mmol/L to(6.98±1.97)mmol/L(t=4.063,P=0.000)and from(7.21±1.57)% to(6.99±1.37)%(t=2.198,P=0.029),respectively after one year intervention with the FBG control rate increasing from 49.81% to 68.16%(χ~2=18.586,P=0.000)and the HbA_(1C)control rate from 46.44%to 59.55%(χ~2=11.670,P0.01).The change of HbA_(1C)level was more statistically significant among patients in intervention group compared with controls(t=4.226,P=0.000;χ~2=38.900,P=0.000). Conclusions Family member-involved community management model for patients with type 2 diabetes from rural areas of Deqing county works better than the traditional one in the controlling of serum levels of FBG and HbA_(1C),which may be adopted widely by rural communities to manage patients.
作者 唐晓梅 唐智峰 张一鸣 沈忠伟 黄建君 王学才 TANG Xiao-mei , TANG Zhi-feng, ZHANG Yi-ming, SHEN Zhong-wei, HUANG Jian-jun, WANG Xue-cai (People's Hospital of Deqing, Deqing, Zhejiang 313200, China)
出处 《中国预防医学杂志》 CAS CSCD 2018年第2期124-128,共5页 China Preventive Medicine
基金 湖州市科技计划项目(2014GY28)
关键词 2型糖尿病 农村 社区管理模式 家属 空腹血糖 糖化血红蛋白 控制率 Type 2 diabetes Rural area Community management model Family member involved FBG HbA1c Control rate
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