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目的评价在社区中开展糖尿病患者综合干预的效果,探索可推广的社区糖尿病干预方法。方法于2008年4月在北京市朝阳区多个社区卫生服务中心依据知情同意的原则选择502名建档管理满1年、年龄30岁以上的2型糖尿病患者进行为期4年的综合干预,在干预前后对每名干预者进行问卷调查、体格检查及血糖、血脂、糖化血红蛋白(HbA1C)检测,用χ2检验对干预前后的相关指标进行比较,对干预效果进行评价。结果经过4年的综合干预,研究对象的空腹血糖达标率为69.4%,较干预前提高7.4%,差异有统计学意义(χ~2=5.568,P<0.05);餐后2 h血糖达标率为62.4%,较干预前提高15.8%,差异有统计学意义(χ~2=23.485,P<0.01);HbA1C达标率为76.4%,较干预前提高21.6%,差异有统计学意义(χ~2=48.329,P<0.01);血压达标率为34.6%,较干预前提高6.3%,差异有统计学意义(χ~2=4.398,P<0.05),但血脂达标率及体质指数达标率干预前后差异均无统计学意义(P>0.05)。经干预,研究对象的行为生活方式、日常监测及遵医嘱服药率均有明显改善,与干预前比较,差异均有统计学意义(P<0.01)。结论综合干预可有效改善社区糖尿病患者生活行为方式、监测及服药行为,提高血糖、血压达标率,降低糖尿病患者的危险因素水平。
Objective To evaluate the effect of comprehensive intervention in patients with diabetes mellitus in community and to explore a possible community diabetes intervention. Methods In April 2008, 502 community health service centers in Chaoyang District, Beijing were selected based on the principle of informed consent for 502 years of management of a year-long, over the age of 30 patients with type 2 diabetes for a 4-year comprehensive intervention in Before and after the intervention, questionnaire, physical examination and blood glucose, blood lipid and HbA1C were conducted for each intervention. The relevant indicators before and after intervention were compared by χ2 test, and the intervention effect was evaluated. Results After four years of comprehensive intervention, the target rate of fasting blood glucose was 69.4%, which was 7.4% higher than that before intervention (χ ~ 2 = 5.568, P <0.05) (Χ ~ 2 = 23.485, P <0.01). The compliance rate of HbA1C was 76.4%, which was 21.6% higher than that before intervention, with a significant difference (χ ~ 2 = 48.329, P <0.01). The blood pressure compliance rate was 34.6%, which was 6.3% higher than that before intervention (χ ~ 2 = 4.398, P <0.05), but the blood lipid compliance rate and body mass index compliance rate Before and after the difference was not statistically significant (P> 0.05). After intervention, the subjects’ behavioral lifestyle, routine monitoring and medication compliance rate were significantly improved, with statistical significance (P <0.01). Conclusion The comprehensive intervention can effectively improve the life style, monitoring and medication behavior of diabetic patients, improve the blood glucose and blood pressure compliance rate and reduce the risk factors of diabetes patients.