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目的探讨糖尿病足在社区监测的可行性。方法随机选择2010年7—8月在海运仓小区确诊为2型糖尿病的患者82例为研究对象,参考中国2型糖尿病防治指南(2007年版)、英国、美国、澳大利亚及亚太地区关于糖尿病足的指南,根据东城区社区卫生服务管理中心所要求的电子病历书写模式,制定出一套规范的SOAP评估模板。检查包括双足的外观、动脉、振动觉情况3项,根据3项检查的结果进行风险评估、制定复查标准,并记录诊疗过程的时间。结果 82例2型糖尿病患者中11例拒绝足部检查;71例患者愿意接受足部检查,接受率为87%,其中3项检查均正常者42例,占59%;任何1项异常者15例,占21%;任何2项异常者12例,占17%;3项均异常者2例,占3%。诊疗全过程对于病情较轻者耗时15～17 min,对于病情复杂者耗时约20 min。结论从患者的接受率及社区医生的人力资源和时间上来看,在社区进行糖尿病足的监测与筛查完全可行。
Objective To investigate the feasibility of diabetic foot monitoring in the community. Methods Totally 82 patients diagnosed with type 2 diabetes from July to August in 2010 were selected as the research objects. According to the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2007 Edition), the prevalence of diabetic foot in Britain, the United States, Australia and Asia Pacific Guidelines, according to the Dongcheng District Community Health Service Management Center required electronic medical record writing mode, to develop a standardized SOAP assessment template. The examination included three appearances of the feet, the arterial and vibration sensations, the risk assessment based on the results of the three tests, the establishment of the review criteria, and the recording of the timing of the treatment. RESULTS: Of the 82 patients with type 2 diabetes, 11 refused to have foot examination. 71 patients were willing to receive foot examination, the acceptance rate was 87%, of which 42 were normal, and 59% were normal; 15 Cases, accounting for 21%; any two abnormalities in 12 cases, accounting for 17%; 3 were abnormal in 2 cases, accounting for 3%. The whole process of diagnosis and treatment for the less severe cases took 15 ~ 17 min, for complicated cases took about 20 min. Conclusion From the patient acceptance rate and community doctor’s human resources and time point of view, it is feasible to monitor and screen diabetic foot in the community.