全程健康教育模式对2型糖尿病治疗达标率的作用

摘要

目的：探讨门诊-住院-出院后全程健康教育模式对2型糖尿病治疗达标率的作用.方法：选择2009年3月-2010年9月在武汉市武昌医院内分泌科就诊的2型糖尿病患者230例，随机分为两组：实验组120例采用门诊-住院-出院后全程健康教育模式，对照组110例采用传统教育模式，观察6个月.比较两组入院时、出院时、出院后3个月、出院后6个月的血压、血糖、血脂达标率以及血清超敏 C 反应蛋白(hsCRP)浓度的变化、依从性的变化、低血糖事件发生率、急慢性并发症发生率.结果：出院后3个月与出院时相比，实验组 SBP、DBP、FBG、2 h BG、HbA1c、TG、LDL-C 等达标率大于对照组(P<0.05)，依从性优于对照组，低血糖事件较对照组减少(P<0.05)；出院后6个月与出院时、出院后6个月与出院后3个月分别作比较，实验组 BMI、SBP、DBP、FBG、2 h BG、HbA1c、TG、TC、LDL-C、HDL-C 等指标达标率均明显优于对照组(P<0.01)，实验组遵医率明显高于对照组(P<0.01)，实验组较对照组 hsCRP、低血糖事件发生率、急慢性并发症发生率均下降(P<0.05).结论：采用门诊-住院-出院后全程健康教育模式对患者进行管理明显提高了患者血压、血糖、血脂达标率，提高了患者治疗的依从性，减少了低血糖事件及急慢性并发症的发生.%Objective: To discuss the effect of the out-patient-hospital-discharged the whole health education mode on the standard reaching rate of type 2 diabetes treatment.Method:Choose type 2 diabetic patients 230 cases who were treated in Wuhan City Wuchang hospital Department of endocrinology from 2009 March to 2010 September.230 cases patients were randomly divided into 2 groups:treatment group 120 cases by clinic-hospital-after discharge of whole course health education mode,110 cases in the control group using the traditional education mode,and observed for 6 months. Two groups were compared at admission,discharge,3 months after discharge,6 months after discharge of the standard reaching rate of blood pressure, blood glucose,blood lipids,serum high sensitivity C-reactive protein(hsCRP)concentration changes,the compliance behaviors,hypoglycemia events and the incidence of acute and chronic complications.Result:At 3 months after discharge versus at discharge the level and standard reaching rate of SBP, DBP,FBG,2 h BG,HbA1c,TG,LDL-C,HDL-C were better in treatment group than in control group(P<0.05),the compliance rate was greater than that of the control group(P<0.05),the hypoglycemic events were less than those in control group(P<0.05).At 6 months after discharge versus at discharge,6 months after discharge and 3 months after discharge,the level and standard reaching rate of SBP,DBP,FBG,2 h BG,HbA1c,TG, LDL-C,HDL-C were significantly better in treatment group than in control group(P<0.01),the compliance rate of experimental group was significantly higher(P<0.01),the levels of hsCRP in the control group,the incidence of hypoglycemia,acute and chronic complications rate decreased(P<0.05). Conclusion:Using the out-patient-hospital-discharged the whole health education model for patients significantly increase the standard reaching rate of blood pressure,blood glucose and blood lipids,improve patient adherence to treatment,reduce the occurrence of hypoglycemic episodes and acute, chronic complications.