摘要
目的 探讨基于三高共管模式健共体照护门诊的糖尿病(diabetes mellitus,DM)患者干预管理对代谢控制的影响.方法 纳入青岛市城阳区流亭卫生院(三高基地)的高血糖患者1198例,DM患者700例,DM前期498例.2019年3月份之前实施传统管理方法即为基层医疗机构和二级以上医疗机构专科团队分裂管理措施,2019年3月份之后创新实施三高共管,通过青岛市城阳区人民医院(三高中心)联合键共体的三高基地及辖区卫生室(三高之家),形成照护门诊团队一体化闭环管理,每周一次、一对一诊治DM患者,检测生化指标,统计学分析采用SPSS19.0.结果 与基线相比,DM亚组体质量指数(BMI)、空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(HbA1c)及总胆固醇(TC)、低密度脂蛋白为(LDL)、收缩压(SBP)、舒张压(DBP)显著下降(P＜0.05).与基线相比,DM前期亚组的BMI、FPG、PBG、HbA1c及TC、LDL显著下降(P＜0.05).DM亚组BP、HbA1c、LDL、BMI及四项代谢指标同时达标率干预后较干预前明显提高(P＜0.05).结论 基于三高共管的健共体照护门诊对于DM患者的干预管理能够改善高血糖人群的血糖、血压、血脂及体重等代谢控制,可在慢病管理中推广应用.
Abstract
Objective To explore the effect of intervention management on metabolism control of diabetic patients based on three height patients and community care clinic.Methods 1198 hy-perglycemic patients,700 diabetic patients,and 498 pre diabetic patients were included in the Liuting Health Center(Three High Base)in Chengyang District,Qingdao City.Before March 2019,the traditional management method was implemented as a split management measure be-tween grassroots medical institutions and specialized teams of medical institutions at or above the second level.After March 2019,innovative measures were implemented to jointly manage the three highs.Through the joint efforts of Qingdao Chengyang District People's Hospital(Three High Center)and the Three High Base of the Key Community and the Health Room(Three High Home)in the jurisdiction,an integrated closed-loop management of the care outpatient team was formed.DM patients were treated once a week,one-on-one,and biochemical indicators were tested.Statistical analysis was conducted using SPSS 19.0.Results Compared with base-line,the DM subgroup showed significant reductions in body mass index(BMI),fasting blood glucose(FBG),postprandial blood glucose(PBG),glycated hemoglobin(HbA1c)and total cho-lesterol(TC),low-density lipoprotein(LDL),systolic blood pressure(SBP),and diastolic blood pressure(DBP)(P＜0.05).Compared with baseline,the BMI,FPG,PBG,HbA1c,TC,and LDL of the pre DM subgroup were significantly reduced(P＜0.05).The simultaneous achieve-ment rates of BP,HbA1c,LDL,BMI,and four metabolic indicators in the DM subgroup were significantly improved after intervention compared to before intervention(P＜0.05).Conclusion The intervention management of DM patients based on three height patients and community care clinic can improve the metabolic control of hyperglycemia,blood pressure,Blood Lipid and body weight,which can be used in the management of chronic diseases.
基金项目
青岛市医药指导计划(2019)(2019-WJZD182)
NETL
NSTL
维普
万方数据