医联体模式下糖尿病视网膜病变社区干预效果研究  

Effect of community intervention on diabetic retinopathy under medical conjoined mode

作　　者：王登学 刘露霞 许光军[1] 刘珏[1] 陈再洪[1] WANG Dengxue;LIU Luxia;XU Guangjun;LIU Jue;CHEN Zaihong(Department of Ophthalmology,Chongqing Emergency Medical Center,Chongqing 400014,China;Daxigou Community Health Service Center of Yuzhong District,Chongqing 400000,China)

机构地区：[1]重庆市急救医疗中心眼科,400014 [2]重庆市渝中区大溪沟街道社区卫生服务中心,400000

出　　处：《重庆医学》2020年第11期1855-1858,共4页Chongqing medicine

基　　金：重庆市渝中区软科学研究项目(20170151)。

摘　　要：目的评价医联体模式下糖尿病视网膜病变(DR)社区干预的效果,为探索DR的社区防控模式提供依据。方法随机抽取2017年12月重庆市大溪沟社区慢病管理档案中确诊为2型糖尿病(T2DM)的患者930例,进行眼底检查。对确诊为DR的268例患者实施干预1年,对患者干预前后最佳矫正视力(BCVA)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血压(BP)、血脂及对DR认知度进行对比分析。结果1年完成了253例DR患者的社区干预,干预后患者BCVA较干预前明显改善,差异有统计学意义(P<0.05);干预后患者FBG、HbA1c、收缩压、舒张压、血脂均较干预前控制情况明显好转,差异有统计学意义(P<0.05);干预后患者对DR认知度较干预前明显提高,差异有统计学意义(P<0.05)。结论医联体模式下三甲医院与社区卫生服务中心为一体的DR社区干预管理,可有效提高患者对DR认知度,增强定期随访意识,有效防控DR病情进展。Objective To evaluate the effect of community intervention on diabetic retinopathy(DR)under the medical conjoint mode,and provide a basis for exploring the DR community prevention.Methods A total of 930 patients with type 2 diabetes mellitus in December 2017 which were in chronic diabetes mellitus management of Daxigou community were randomly selected for fundus screening.One-year comprehensive intervention and following-up were carried out on 268 patients diagnosed with diabetic retinopathy(DR).The changes of best corrected visual acuity(BCVA),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),blood pressure(BP),blood lipids and DR cognition before and after intervention were observed and comparative analyzed.Results A total of 253 patients with DR completed the community intervention for 1 year.The patients′cognition for DR was significantly improved after intervention,and the difference was statistically significant(P<0.05).FBG,HbA1c,systolic pressure,diastolic pressure,blood lipids were significantly improved after the intervention,and the difference was statistically significant(P<0.05).After intervention,patients′cognition for DR was significantly improved compared with that before intervention,and the difference was statistically significant(P<0.05).Conclusion The comprehensive intervention management of diabetic retinopathy with tertiary hospital and community health service center under medical conjoined mode can effectively improve patients`cognition for DR,enhance the awareness of regular following-up,and effectively prevent and control the disease progression.

关 键 词：糖尿病 糖尿病视网膜病变 社区干预 

分 类 号：R774[医药卫生—眼科]