上虞市农村社区糖尿病防治管理短期效果评价  

Short-term Effectiveness Evaluation on Diabetes Management on Prevention and Treatment in Shangyu rural Community

作　　者：周国峰 胡松林[2] 陈炯炯[2] 

机构地区：[1]上虞市驿亭镇卫生院,浙江上虞312300 [2]上虞市疾病预防控制中心,浙江上虞312300

出　　处：《中国初级卫生保健》2013年第9期75-77,共3页Chinese Primary Health Care

摘　　要：目的探讨农村社区糖尿病防治管理工作方式和管理效果。方法设定辖社区糖尿病防治管理短期指定目标,采取以社区卫生服务站点为基础、以"一村一医"责任制为主体的社区全科团队模式开展糖尿病防治管理工作。结果 3年累计发现和建档糖尿病患者315人,患病率为1.42%,规范管理率为85.40%;在40岁以上人群中筛选出糖尿病高危人群382人,筛出率为14.86%,每年1次测血糖率为67.02%,确诊高危人群糖尿病患病率为3.14%;抽样调查120名糖尿病患者,对自己血糖值的知晓率为84.17%,糖尿病危险因素知晓率为87.17%,糖尿病危害知识知晓率为86.67%。随访调查所有糖尿病患者,糖尿病患者对糖尿病危险因素知晓率达95.87﹪,对危害知识知晓率达97.14%;糖尿病患者能够遵医嘱规范治疗,血糖控制在正常值或接近正常值范围的患者达72.00%。结论在农村社区卫生服务站点开展以"一村一医"责任制为主体的社区全科医生团队模式的糖尿病防治管理,短期效果显著,是社区糖尿病综合防治干预管理的可靠途径。OBJECTIVE To discuss the manner of working and management effect on diabetes management about prevention and treatment in rural community.METHODS Make the short-term objectives of diabetes management about prevention and treatment in community,and develop the management on the base of community health service station,with one community one general practitioner doctor responsibility.RESULTS Totally 315 diabetes were found and all the health record had been created through 3 years,the prevalence was 1.42%,the normal-management rate was 85.40%.382 people with high risk on diabetes were screened out,the prevalence was 14.86%,67.02% of them tested blood sugar at least one time a year,the prevalence of diabetes in the people with high risk was 3.14%.Among the 120 people in sampling survey,the awareness rate of blood sugar of one＇s own,risk factors of diabetes,and knowledge of hazards was 84.17%,87.17% and 86.67% respectively.Meanwhile,the awareness rate of risk factors of diabetes,knowledge of hazards was 95.87%,97.14% respectively in all the people with diabetes.The rate of treatment was 72.00% for people who could follow doctor＇s advice.CONCLUSION The management mode of diabetes at the base of rural community health service station,with ＂one community one general practitioner doctor responsibility＂ can make a significant short-term effect,which is a reliable method to make a comprehensive prevention and treatment to diabetes in rural community.

关 键 词：社区 糖尿病 防治管理 效果评价 

分 类 号：R587.1[医药卫生—内分泌]