2型糖尿病统一标准化延续性管理模式的应用效果观察

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摘要目的分析统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。

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	赵玲缪园园▲ 柯亭羽周湘明

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

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

基金资助:国家自然科学基金资助项目（81760327）；
云南省科学技术厅中青年学术和技术带头人后备人才培养项目（2017HB049）；
云南省科技厅基础研究计划昆医联合专项基金项目[2018FE001（-228）]；
云南省卫生计生委高层次卫生计生技术人才培养项目（H-2017043）；
云南省教育厅科学研究基金项目（2017zzx202、2017zDX194）；
云南省卫生科技计划项目（2018NS0293）；
昆明医科大学第二附属医院人才培养计划项目（RCPYXM2017-3-16）。

通讯作者: ▲通讯作者

引用本文:

赵玲缪园园▲ 柯亭羽周湘明. 2型糖尿病统一标准化延续性管理模式的应用效果观察[J]. 中国医药导报, 2020, 17(21): 70-73.
ZHAO Ling MIAO Yuanyuan▲ KE Tingyu ZHOU Xiangming. Observation on the application effect of unified standardization continuity management mode for type 2 diabetes. 中国医药导报, 2020, 17(21): 70-73.

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