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目的调查南通市二级医院糖尿病患者的住院管理现状,探讨开展糖尿病诊断与治疗质量控制的必要性。方法随机抽取276份以2型糖尿病为第一诊断的病历,根据《中国糖尿病防治指南》(2004)对糖尿病控制管理的基本要求,对住院病历进行糖尿病住院管理登记调查。结果①代谢指标与体格检查指标:糖化血红蛋白、血脂、血压、身高、体重及腰围的检查率分别为38.0%、81.9%、98.9%、9.8%、52.9%和4.0%,平均血糖监测次数为(3.6±2.4)次/d。②糖尿病慢性并发症筛查:心电图、心脏超声、血管超声、肾功能、尿微量白蛋白、眼底以及下肢神经的检查率分别为83.0%、22.1%、27.9%、94.9%、33.0%、23.9%和8.0%。③综合治疗与生活方式干预:抗高血压、调节血脂以及阿司匹林使用率分别为80.1%、40.6%和29.1%;仅6.9%的出院医嘱含有饮食治疗指导计划,出院运动治疗指导率仅为0.7%。④出院时代谢指标及血压的治疗达标率:血糖控制理想率、降压治疗达标率分别为23.9%和20.8%。结论糖尿病患者住院管理的质量亟待提高,很有必要加强糖尿病防治工作的质量控制。
Objective To investigate the status of hospitalized patients with diabetes in Nantong Second Hospital and to discuss the necessity of quality control in diagnosis and treatment of diabetes mellitus. Methods A total of 276 cases of type 2 diabetes mellitus were selected randomly. According to the basic requirements of diabetes control and management in Guidelines for Prevention and Treatment of Diabetes in China (2004), the hospitalization records of inpatients were reviewed. Results ① Metabolic indexes and physical examination indexes: The rates of HbA1c, blood lipid, blood pressure, height, body weight and waist circumference were 38.0%, 81.9%, 98.9%, 9.8%, 52.9% and 4.0% 3.6 ± 2.4) times / d. The screening rate of chronic complications of diabetes were 83.0%, 22.1%, 27.9%, 94.9%, 33.0% and 23.9% respectively in electrocardiogram, echocardiography, blood vessel ultrasound, renal function, urine microalbumin, fundus and lower extremity nerve. And 8.0%. ③ Comprehensive treatment and lifestyle intervention: anti-hypertension, lipid-lowering and aspirin use rates were 80.1%, 40.6% and 29.1% respectively; only 6.9% of discharged patients’ orders included dietary treatment plans and the discharge rate was only 0.7% . Discharged metabolic indicators and blood pressure treatment compliance rate: the ideal rate of blood glucose control, blood pressure treatment compliance rates were 23.9% and 20.8%. Conclusion The quality of hospitalized patients with diabetes need to be improved urgently, it is necessary to strengthen the quality control of diabetes prevention and treatment work.