赵玲 缪园园 柯亭羽 周湘明

[摘要] 目的 分析統一标准化延续性管理模式对2型糖尿病（T2DM）患者行为改变、血糖控制效果的影响。 方法 选择2017年11月—2018年11月在昆明医科大学第二附属医院国家标准化代谢性疾病管理（MMC）中心就诊的220例T2DM患者，根据随机数字表法分为对照组和实验组，每组110例。对照组实施常规管理模式，实验组采用统一标准化延续性管理（即MMC管理模式）。对两组管理前后血糖变化、自我管理水平及护理满意度进行比较。结果 干预后，两组糖化血红蛋白（HbA1c）、空腹血糖（PBG）水平均低于干预前，实验组餐后血糖（FPG）低于干预前，且实验组FPG、PBG、HbA1c低于对照组，差异均有高度统计学意义（均P < 0.01）。两组合理饮食、运动、血糖自我检测、规范用药评分高于干预前，且实验组合理饮食、运动、血糖自我检测、规范用药评分均高于对照组，差异均有统计学意义（均P < 0.05）。实验组护理满意度高于对照组，差异有统计学意义（P < 0.05）。 结论 MMC管理模式有助于提高T2DM患者FPG、PBG、HbA1c的达标率，能有效地改善T2DM患者的自我管理行为，提高患者满意度，具有临床推广应用价值。

[关键词] 国家标准化代谢性疾病管理中心;统一标准化延续性护理管理模式;2型糖尿病;血糖达标;行为改变

[中图分类号] R587.1          [文献标识码] A          [文章编号] 1673-7210（2020）07（c）-0070-04

Observation on the application effect of unified standardization continuity management mode for type 2 diabetes

ZHAO Ling   MIAO Yuanyuan▲   KE Tingyu   ZHOU Xiangming

Department of Endocrinology， the Second Affiliated Hospital of Kunming Medical University， Yunnan Province， Kunming   650101， China

[Abstract] Objective To analyze the impact of unified and standardized continuity management mode on behavior change and blood glucose control effect of patients with type 2 diabetes （T2DM）. Methods From November 2017 to November 2018， 220 patients with T2DM who were treated at the National Metabolic Management Center （MMC） of the Second Affiliated Hospital of Kunming Medical University were selected. According to the random number table method， they were randomly divided into control group and experimental group， with 110 cases in each group. The control group implemented a routine management model， and the experimental group performed unified and standardized continuous management （MMC management mode）. Blood glucose， self-management level and nursing satisfaction were compared before and after management. Results After intervention， the levels of glycosylated hemoglobin （HbA1c） and postprandial blood glucose （PBG） in the two groups were lower than those before intervention， fasting glucose （FPG） in the experimental group was lower than those before intervention， and FPG， PBG and HbA1c in the experimental group were lower than those in the control group， with highly statistically significant differences （all P < 0.01）. Scores of rational diet， exercise， blood glucose self-test and standardized drug use in the two groups were higher than those before intervention， and scores of rational diet， exercise， blood glucose self-test and standardized drug use in the experimental group were higher than those in the control group， with statistically significant differences （all P < 0.05）. The nursing satisfaction of the experimental group was higher than that of the control group， and the difference was statistically significant （P < 0.05）. Conclusion The MMC management mode helps to improve the compliance rate of FPG， PBG， and HbA1c in T2DM patients， it can effectively improve the self-management behavior， increase patients′ satisfaction， and has clinical application value.

[Key words] National Standardized Metabolic Disease Management Center; Unified and standardized continuous care management model; Type 2 diabetes; Blood glucose compliance; Behavioral changes

随着物质生活水平提升、生活习惯改变，加上人口老龄化等因素，我国糖尿病患病率呈快速上升趋势，已成为继心血管疾病、肿瘤之后的另一个严重危害人们健康的重要慢性非传染性疾病[1-2]。我国1980年开展30万人口糖尿病流行病学调查发现患病率为0.67%[3]。上海瑞金医院宁光院士科研团队研究新成果揭示：我国18岁以上的人群中糖尿病和糖尿病前期的患病率分别达到了11.6%和50.1%[4]。流行病学调查数据都充分说明我国糖尿病患病率正在节节攀升。饮食、运动、血糖的自我监测、健康教育、心理治疗和药物治疗都是缺一不可的。糖尿病患者常常需要花费大量时间往返于就诊与复诊的过程中。……