社区分级管理对糖尿病足危险因素的控制效果  

Effect of community grade management on the risk factors of diabetic foot

作　　者：魏华伟[1] 刘桂娟[2] 魏玉玲[3] 陈晓侠[1] 戚雯雯[1] 徐丽娟[1] 包金丽[4] 

机构地区：[1]枣庄市立医院新城社区卫生服务中心,山东省277800 [2]枣庄市立医院神经内科,山东省277800 [3]枣庄市立医院内分泌代谢科,山东省277800 [4]枣庄市立医院心内科,山东省277800

出　　处：《中华护理杂志》2012年第10期923-926,共4页Chinese Journal of Nursing

摘　　要：目的探讨社区分级管理对糖尿病足危险因素的控制效果。方法选择社区内86例糖尿病患者随机分为观察组和对照组。对两组患者糖尿病足的危险因素分别进行评估,根据危险程度分为低危、中危、高危组。观察组患者按照不同的危险程度分别纳入不同的管理级别。对照组统一采用常规糖尿病健康教育。结果干预、随访30个月,两组患者糖尿病足溃疡的发生率均为零;观察组中,中危、高危的下降率较对照组明显,差异有统计学意义(P<0.05);观察组干预后的踝肱指数(ABI)、神经传导速度较干预前有显著改善,较对照组明显,差异有统计学意义(P<0.05);观察组干预后患者的糖尿病相关知识及足部自护能力较干预前显著提高,较对照组提高明显,差异有统计学意义(P<0.05)。结论对社区内糖尿病患者足部危险因素实施全方位、多学科协作的社区分级管理,可提高患者的自我管理能力,改善患者的各项代谢指标,对糖尿病足溃疡的发生起到预防作用。Objective To evaluate the effect of community grade management on the risk factors of diabetic foot. Methods Eighty-six community-dwelling patients with diabetes were randomly divided into two groups. Based on the assessment of risk factors of diabetic foot,the patients in both groups were classified into low-risk,medium risk and high risk group. The patients in the experimental group received grade management based on the levels of risk factors of diabetic foot,while the patients in the control group received routine diabetic health education. Results The incidence of diabetic foot ulcers was zero in both groups at 30 months after intervention. The proportion of medium risk and high risk was significantly reduced in the experi mental group than that of the control group（P〈0.05）. The ankle brachial index（ABI） and the nerve conduction velocity were significantly improved in the experimental group than those of the control group（P〈0.05）. Moreover,the patients＇ diabetic-related knowledge and foot self-care ability were significantly improved than before and than that of the control group（P〈0.05）. Conclusions Community grade management by multi-disciplinary staff based on the levels of risk factors of diabetic foot can promote the patients＇ self-management ability, improve the control of metabolic index and prevent diabetic foot.

关 键 词：糖尿病足:社区保健护理 

分 类 号：R473.2[医药卫生—护理学]