医院联合社区管理控制2型糖尿病的效果观察  

The effects of Co-operation of the hospital and community administration on type 2 diabetes patients

作　　者：张云兰[1] 刘雅[2] 欧阳凌云[3] 黄小波[4] 董晓薇 

机构地区：[1]成都市第二人民医院心血管与代谢疾病研究室,四川成都610017 [2]成都市第二人民医院老年科,四川成都610017 [3]成都市第二人民医院内分泌科,四川成都610017 [4]成都市第二人民医院心内科,四川成都610017 [5]成都市龙泉驿仁爱社区,四川成都610100

出　　处：《实用医院临床杂志》2012年第6期60-63,共4页Practical Journal of Clinical Medicine

基　　金：成都市"十一五"科技规划重大专项"城乡社区常见多发慢性病防治"(编号:07YTYB959SF-020)

摘　　要：目的观察医院社区联合管理模式控制2型糖尿病的效果,探讨糖尿病患者的最佳管理模式。方法按照随机数字表将180例2型糖尿病患者分为联合管理组(n=88)和常规管理组(n=92)。联合管理组每月接受医院专业医师的培训和社区医生定期的电话门诊随访,常规管理组接受社区医生常规糖尿病教育和跟踪随访。以糖化血红蛋白、血压、体重指数及血脂为主要评估指标,每半年评估一次,持续监测18个月。结果干预后两组患者空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白均明显改善(均P<0.05),而两组间差异无统计学意义[空腹血糖(P=0.142)、总胆固醇(P=0.124)、甘油三酯(P=0.368)、低密度脂蛋白(P=0.241)。随访满一年后两组患者的血脂和糖化血红蛋白出现了不同程度的反弹。结论医院社区联合管理模式是糖尿病治疗过程中不可忽视的手段,但依然存在诸多不足,需要糖尿病管理者在今后的工作中改进。Objective To investigate the effects co-operation administration of both hospital and community in type 2 diabetes therapy. Methods 180 patients with type 2 diabetes were randomly assigned into two groups by random number table： the combination administration group（ n = 88 ） and the conventional Health Education administration group （n = 92）. The combination administration group accepted the training from the specialists and received the telephone following-up by the physicians from the Community Hospital. The conventional group accepted the routine diabetes training and education. The main points including HbAlc, blood pressure, body mass index and blood lipid were evaluated or accessed every six months and lasted for 18 months. Results At the end of follow-up for 18 months ,the fast glucose level, TC ,TG and LDL were significantly decreased compared with the baseline（ P 〈0.05 while no difference between these two groups including glucose（ P = 0. 142 ） ,TC （P = 0. 124） ,TG （P = 0. 368） and LDL（P = 0.241 ）. There existed a rebound of glycosylated hemoglobin A1c（ HbA1c ） and blood lipid at the end of 12 months. Conclusions The co-operation administration by both hospital and community acted as an important mode for diabetes therapy though still need to be improved in management for diabetes.

关 键 词：医院 社区管理 糖尿病 

分 类 号：R197[医药卫生—卫生事业管理] R197.3[医药卫生—公共卫生与预防医学]