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目的评价社区糖尿病患者契约式干预治疗的效果。方法随机抽取2005年至2008年长期在张掖市医院社区医疗服务中心就诊的2型糖尿病患者,采取自愿的原则,签订健康保健合同(契约),建立健康档案,制定个体化治疗方案,定期上门服务或病人定期到社区医疗中心,给予个体化生活方式指导。干预前后对入选患者进行知信问卷调查,进行自身前后对照分析及综合分析。结果(1)干预后与干预前比较,患者空腹血糖〔(7.2±2.0)vs(8.1±4.8)mmol/L,P<0.05〕、餐后2h血糖〔(9.0±2.5)vs(10.9±7.7)mmol/L,P<0.01〕、糖化血红蛋白〔(7.2±1.7)%vs(8.4±2.3)%,P<0.01〕均显著下降;(2)糖尿病相关知识知晓率干预后较干预前明显上升(P<0.01);(3)干预后,接受综合治疗率由46.7%提高至77.4%(P<0.01),整体血糖控制率从29.3%上升至64.8%(P<0.01)。结论社区糖尿病患者契约式干预治疗可使糖尿病患者获得更好的血糖控制。
Objective To evaluate the effect of contractual intervention in community diabetic patients. Methods A random sample of type 2 diabetic patients attending the Community Medical Service Center of Zhangye Hospital from 2005 to 2008 was selected on a voluntary basis. Health contracts (contracts) were signed, health records were established, individualized treatment plans were formulated, and on-site visits were regularly conducted Or patients to the community medical center regularly to give individualized lifestyle guidance. Before and after the intervention of the selected patients were informed by questionnaires, before and after their own control analysis and comprehensive analysis. Results The fasting blood glucose (7.2 ± 2.0 vs 8.1 ± 4.8 mmol / L, P <0.05) and postprandial blood glucose (9.0 ± 2.5 vs 10.9 ± 7.7 ) mmol / L, P <0.01〕, HbA1c (7.2 ± 1.7)% vs (8.4 ± 2.3)%, P <0.01〕. (2) The awareness rate of diabetes was significantly higher than that before intervention (P <0.01). (3) After intervention, the rate of receiving comprehensive treatment increased from 46.7% to 77.4% (P <0.01), and the overall blood glucose control rate increased from 29.3% to 64.8% (P <0.01). Conclusions Contractual diabetes intervention in diabetic patients achieves better glycemic control.