倪俊+董建超+倪菊花+陈冬冬

摘 要 目的：探讨用强化教育结合患者自我管理的方法对2型糖尿病患者胰岛素规范化注射的影响。方法：选取2014年11月至2015年5月在崇明县港沿镇社区卫生服务中心门诊就医、使用胰岛素注射治疗的2型糖尿病患者共196例，随机分成干预组和对照组各98例，干预组进行胰岛素规范化注射的强化教育结合患者的自我管理，对照组单纯采用教育的方法干预，两组分别在第1周和第12周进行相应干预各2次，在干预前、入组后第8周和第24周用自制量表对两组患者各进行3次评估。结果：干预组在入组后8周和24周时量表得分和合格率均明显优于对照组，差异有统计学意义（P<0.05）；干预组在第24周的得分情况优于第8周，差异有统计学意义（P<0.05）。但是干预组在第24周的合格率与第8周比较无明显统计学差异（P>0.05）。结论：强化教育结合患者的自我管理对胰岛素规范化注射的影响明显优于单纯采用教育的方法，且干预效应稳定。

关键词 强化教育 自我管理 胰岛素规范化注射

中图分类号：R587.1 文献标识码：A 文章编号：1006-1533（2016）06-0044-04

Influence of the intensive education combined with the self- management on the standardized insulin injection

NI Jun1， DONG Jianchao1， NI Juhua1， CHEN Dongdong2*

（1. Gangyan Community Health Service Center of Chongming County， Shanghai 202158， China；

2. Shanghai Community Health Association， Shanghai 200041， China）

ABSTRACT Objective： To discuss the influence of the intensive education combined with the patient self-management on the standardized insulin injection in the patients with type 2 diabetes mellitus. Methods： Total of 196 cases who were diagnosed as type 2 diabetes mellitus and treated with the insulin injection from Nov. 2014 to May 2015 in Gangyan Community Health Service Center in Chongming County were chosen and randomly divided into an intervention group and a control one with 98 cases each. The intervention group was intervened with the intensive education combined with the patient self-management and the control group only with the education. These groups were intervened two times in the first and twelfth weeks respectively. The patients in the two groups were evaluated 3 times with the self-made scales before the intervention and in the eighth and 24th weeks after being enrolled into the study. Results： The scale score and qualified rate were significantly better in the intervention group after 8 weeks and 24 weeks than those in the control group， and the difference had the statistical significance （P<0.05）. The score was higher in 24 weeks than 8 weeks in the intervention group （P<0.05）， but there was no significant difference in the qualified rate between 24 weeks and 8 weeks in the intervention group （P>0.05）. Conclusion： The effect of the intensive education combined with the patient self-management on the standardized use of insulin injection for the patients with 2 diabetes mellitus is better than that of the simple education method and the intervention effect is stable.

KEY WORDS intensive education； self-management； standardized insulin injection

因生活方式的改变，中国乃至全球糖尿病发病率和患病率急剧增长，糖尿病已成为严重威胁人类健康的主要慢性病之一。而亦随着糖尿病病程的进展，患者的胰岛细胞功能随病程进展逐渐恶化[1]，为取得血糖最佳控制，大部分2型糖尿病患者似乎最终均需胰岛素治疗[2]。长期以来，对糖尿病患者的饮食，运动，及药物治疗方面的社区管理均取得明显的发展，但在胰岛素注射技术近况的调查显示在胰岛素注射技术上比较欠缺，不规范注射现象普遍存在[3]，这一问题在一定程度上直接影响了胰岛素治疗的效果及患者对胰岛素注射治疗的依从性，最终导致血糖达标率降低[4]。……