赵超+沈德蕾+许闯

摘 要 目的：观察社区2型糖尿病患者短期（3个月）自我管理效果。方法：2015年7月抽取糖尿病管理系统中102例2型糖尿病患者，分为研究组54例和对照组48例。两组患者均在常规药物治疗基础上，给予干预管理3个月，研究组采用糖尿病自我支持管理，对照组则采用常规社区综合干预。分别记录两组患者血压，体质指数（BMI）以及总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、空腹血糖（FBG）和糖化血红蛋白（HbAlc）水平，并进行组间比较。采用糖尿病管理自我效能量表评估患者糖尿病自我管理能力。结果：与干预前比较，研究组患者的血压、BMI以及TC、LDL-C、HDL-C、HbA1c水平均明显改善（P<0.05）；对照组患者的收缩压和TC、LDL-C水平均显著降低（P<0.05）。研究组患者收缩压明显低于对照组（P<0.05）；血压、TC、LDL-C水平控制达标率显著高于对照组（P<0.05），糖尿病自我管理总分提高明显高于对照组（P<0.01）。结论：糖尿病自我支持管理可改善2型糖尿病患者血压，明显提高部分指标控制达标率以及患者的自我管理能力，值得社区推广应用。

关键词 2型糖尿病 自我管理 效果分析

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2016）10-0052-03

Analysis of the effect of short term self-management of the patients with type 2 diabetes mellitus in the community*

ZHAO Chao， SHEN Delei， XU Chuang

（Fenglin Community Health Service Center of Xuhui District， Shanghai 200030， China）

ABSTRACT Objective： To observe the effect of short term（3 months）self-management of type 2 diabetic patients in the community. Methods： In July 2015， 102 cases of type 2 diabetes were selected from the diabetic management system and divided into a research group with 54 cases and a control group with 48 cases. Based on the conventional medical treatment， the two groups were given interventional management for 3 months. The research group was given the diabetic self-support management， and the control group was given the conventional community comprehensive intervention. The levels of blood pressure， body mass index（BMI）， total cholesterol（TC）， triacylglycerol（TG）， low density lipoprotein cholesterol（LDL-C）， high density lipoprotein cholesterol（HDL-C）， fasting blood glucose（FBG）and glycosylated hemoglobin（HbAlc）of the two groups were recorded before and after the management， respectively， and were compared between them. The diabetic self-management ability of the patients was evaluated with diabetic management self-efficacy scale in Chinese version. Results： Compared with before intervention， the levels of blood pressure， BMI， TC， LDL-C， HDL-C， and HbA1c of the patients in the research group were improved obviously（P<0.05）. Meanwhile， the levels of systolic blood pressure（SBP）， TC， and LDL-C of the patients in the control group were decreased markedly（P<0.05）. The SBP of the patients in the research group was significantly lower than that of the patients in the control group （P<0.05）. The control compliance rates of the levels of blood pressure， TC， and LDL-C were significantly in the research group than those in the control group（P<0.05）. The improvement of self-management diabetic sores was significantly higher in the research group than that in the control group（P<0.01）. Conclusion： The diabetic self-support management can improve the blood pressure of type 2 diabetic patients and increase the control compliance rate of some indicators and the selfmanagement ability of type 2 diabetic patients， which is worthy of popularization and application in the community.

KEY WORDS type 2 diabetes； self management； effect analysis

糖尿病是社区常见病、多发病，据相关调查显示，中国成人糖尿病患病率为11.6%，目前有糖尿病患者约1.139亿，中国糖尿病患者人数居全球之首[1]。2型糖尿病是糖尿病的主要类型，占糖尿病患者总数的90%以上[2]；随着我国人口老年化进程的加速和人们生活方式的改变，糖尿病已严重影响人们的健康，给家庭和社区带来沉重的负担。近年来，糖尿病的患病人数逐年增加，虽然在糖尿病治疗与管理方面已有成熟的防治指南，但是患者生活质量的提高仍有赖于自我管理[3-5]。目前，我国糖尿病患者的自我管理教育还处在起步阶段，糖尿病患者的自我管理水平也不高，如何提高糖尿病患者的自我管理能力任务艰巨[6]。本研究旨在观察社区2型糖尿病患者短期自我管理效果，为社区糖尿病管理提供新模式，使患者对糖尿病有一个较为全面的认识并掌握糖尿病自我管理的能力和技巧。……