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目的探索糖尿病防治的最佳模式,提高糖尿病患者的治疗达标率,减少慢性并发症,降低医疗费用。方法选取286名2型糖尿病患者,随机分为观察组和对照组,其中观察组144例,对照组142例。对观察组采用健康教育、规范化治疗、随访管理以及和乡镇卫生院双向转诊相结合的一体化防治管理模式。对照组不进行指导,完全依赖患者的自觉行为。24周后比较两组患者空腹血糖、餐后两小时血糖及糖化血红蛋白水平。结果观察组空腹血糖平均为(5.2±1.2)mmol/L,餐后两小时血糖平均为(8.8±1.9)mmol/L,糖化血红蛋白平均为(6.2±1.1)%;对照组空腹血糖平均为(7.5±1.3)mmol/L,餐后两小时血糖平均为(11.1±1.5)mmol/L,糖化血红蛋白平均为(7.8±1.2)%(P<0.01);观察组无一例新发生慢性并发症,对照组新发生慢性并发症者3例;医疗费用方面:观察组平均(232.0±36.0)元/月,对照组平均(268.0±38.0)元/月,两组差异有显著性(P<0.01)。结论对2型糖尿病患者采用健康教育、规范化治疗、随访管理以及和乡镇卫生院双向转诊相结合的一体化防治管理模式,可以显著提高血糖的控制率,减少慢性并发症的发生,且能降低医疗费用,值得推广。
Objective To explore the best mode of prevention and treatment of diabetes to improve the treatment compliance rate of diabetic patients, reduce chronic complications and reduce medical costs. Methods Totally 286 patients with type 2 diabetes were randomly divided into observation group and control group, 144 cases in observation group and 142 cases in control group. The observation group using health education, standardized treatment, follow-up management and two-way referral with township hospitals integrated management and prevention mode. The control group did not guide, completely dependent on the patient’s conscious behavior. After 24 weeks, fasting blood glucose, two-hour postprandial blood glucose and HbA1c were compared between the two groups. Results The average fasting blood glucose in the observation group was (5.2 ± 1.2) mmol / L, mean postprandial blood glucose was (8.8 ± 1.9) mmol / L, and average glycosylated hemoglobin was (6.2 ± 1.1)% in the observation group 7.5 ± 1.3) mmol / L, the average blood glucose level was (11.1 ± 1.5) mmol / L and the average HbA1c (7.8 ± 1.2)% at two hours postprandial. No new chronic complications occurred in the observation group, There were 3 cases of chronic complications in the control group. The average cost of medical treatment was 232.0 ± 36.0 yuan / month in the observation group and 268.0 ± 38.0 yuan / month in the control group (P <0.01) . Conclusion The integrated management and control mode of combining health education, standardized treatment, follow-up management and bidirectional referral with township hospitals in patients with type 2 diabetes can significantly increase the control rate of blood glucose, reduce the incidence of chronic complications and reduce the incidence of chronic complications Medical expenses, worth promoting.