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目的探讨糖尿病患者社区一体化规范化管理的效果。方法将糖尿病患者随机分为管理组60例和对照组60例,对照组采用传统分组管理模式,由社区公共卫生医生按照分组定期随访,患者主动就医;管理组在此基础上,采用“公共卫生医生——全科医生——专科医生”一体化管理模式,两组对象均通过定期检测空腹血糖、糖化血红蛋白、餐后2 h血糖及血脂指标,评价糖尿病患者规范化管理的效果。结果干预1年后,管理组的空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇和甘油三酯均较干预前明显下降,干预前后差异有统计学意义(P<0.05);与对照组比较,管理组在干预后的空腹血糖、餐后2 h血糖、糖化血红蛋白和甘油三酯下降程度大于对照组,两组差异有统计学意义(P<0.05),但干预后两组血清总胆固醇、高密度脂蛋白和低密度脂蛋白均数比较,差异均无统计学意义(P>0.05)。结论采用社区一体化管理模式对糖尿病患者实施干预,可更好地改善患者的糖脂代谢。
Objective To explore the effect of standardized management of community integration in patients with diabetes mellitus. Methods Diabetic patients were randomly divided into two groups: control group (60 cases) and control group (60 cases). The control group was treated by traditional group management mode. The community public health physicians regularly followed the patients according to grouping. The management group used “public Health doctor - general practitioner - specialist ”integrated management model, the two groups of subjects through regular testing of fasting blood glucose, glycosylated hemoglobin, 2 h postprandial blood glucose and lipid indicators to assess the effect of standardized management of patients with diabetes. Results After 1 year of intervention, the fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, total cholesterol and triglyceride in the management group decreased significantly compared with those before intervention (P <0.05); compared with the control group (P <0.05). However, the levels of fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin and triglyceride in the management group after intervention were higher than those in the control group (P <0.05) There was no significant difference in the mean of high-density lipoprotein and low-density lipoprotein (P> 0.05). Conclusion Community-based management mode intervention in patients with diabetes, can better improve the patient’s glucose and lipid metabolism.