沙琳

[摘要] 目的 探究醫联体中采用医院-社区护理模式对糖尿病患者血糖自我监测能力及血糖代谢指标的影响。 方法 采用前瞻性研究方法，选择丽水市中心医院2018年5月～2019年5月收治的糖尿病患者89例为本次研究对象，按照护理模式不同将其分为对照组44例（常规护理）与观察组45例（医联体模式下医院-社区护理）。比较两组患者血糖自我监测能力、血糖代谢指标、低血糖事件发生率及自我管理行为。 结果 出院时两组患者血糖自我监测能力评分比较，差异无统计学意义（P>0.05），1个月后、2个月后观察组血糖自我监测能力评分均高于对照组，差异有统计学意义（P<0.05）;出院时两组患者BMI、FBG、2hPG、HbAlc比较，差异无统计学意义（P>0.05）;1个月后、2个月后观察组各指标均明显低于对照组，差异有统计学意义（P<0.05）;观察组低血糖事件发生率为4.44%，对照组发生率为29.55%，差异有统计学意义（P<0.05）;1个月后、2个月后观察组DSCS评分均明显高于对照组，差异有统计学意义（P<0.05）。 结论 医联体模式下对糖尿病患者开展医院-社区护理模式有助于提升患者血糖自我监测能力，改善血糖代谢指标，降低低血糖事件发生率，提升患者血糖自我管理能力，值得应用与推广。

[关键词] 医联体模式;医院—社区护理模式;自我血糖监测;代谢;低血糖

[中图分类号] R473.2          [文献标识码] B          [文章编号] 1673-9701（2020）22-0178-04

Effect of hospital-community care mode under medical union on blood glucose self-monitoring ability and metabolism index in diabetic patients

SHA Lin

Department of Endocrinology， Lishui Central Hospital in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To investigate the effect of hospital-community nursing model on blood glucose self-monitoring ability and metabolism index in diabetic patients. Methods 89 cases of diabetic patients admitted to Lishui Central Hospital from May 2018 to May 2019 were selected for this study by prospective study. According to different nursing models， they were divided into control group with 44 patients（conventional care） and observation group with 45 patients（hospital-community care in the medical union mode）. The blood glucose self-monitoring ability， blood glucose metabolism index， hypoglycemia event rate and self-management behavior were compared between the two groups. Results There was no significant difference in blood glucose self-monitoring ability between the two groups at the time of discharge（P>0.05）. After 1 month and 2 months， the blood glucose self-monitoring ability scores of the observation group were higher than those of the control group， and the difference was statistically significant（P<0.05）. There were no significant differences in BMI， FBG， 2hPG and HbAlc data between the two groups at discharge（P>0.05）. After 1 month and 2 months， the indicators in the observation group were significantly lower than those in the control group， and the difference was statistically significant（P<0.05）. The incidence of hypoglycemia in the observation group was 4.44%， and the incidence in the control group was 29.55%， and the difference was statistically significant（P<0.05）. After 1 month and 2 months， the DSCS scores of the observation group were significantly higher than those of the control group， and the difference was statistically significant（P<0.05）. Conclusion The hospital-community care mode under medical union mode for diabetes patients can improve the self-monitoring ability of blood glucose， improve blood sugar metabolism index， reduce the incidence of hypoglycemia events， and improve the self-management ability of patients' blood sugar. It is worthy of application and promotion.

[Key words] Medical union mode; Hospital-community care mode; Self-glycemic monitoring; Metabolism; Hypoglycemia

糖尿病已成为继肿瘤、心脑血管疾病后第三位严重慢性疾病，其发病率呈上升趋势，据我国7次全国性糖尿病流行病学调查情况显示，我国糖尿病患病率高达10.4%[1];2018年国际糖尿病联盟发布的第8版全球糖尿病地图显示，全球共计4.25亿成人糖尿病患者，我国患者数量1.14亿，居世界首位。2017年我国有超过84万患者死于糖尿病，其中60岁以下患者比例高达33.8%[2]。糖尿病血糖自我监测能够为血糖控制提供可靠依据，医院—社区护理模式能够为糖尿病患者出院后提供持续护理服务，有助于提升糖尿病患者血糖控制效果。为提升糖尿病患者血糖自我监测能力，丽水市中心医院特开展医联体模式下医院—社区护理模式，探究该模式对糖尿病患者血糖自我监测能力及血糖代谢指标的影响，现报道如下。