社区服务团队对社区糖尿病患者规范管理的临床分析

目的研究社区医疗机构服务团队对糖尿病患者的规范管理，探讨社区服务对糖尿病患者的影响。方法选择2011年3月至2012年3月首次在社区治疗的200例2型老年糖尿病患者，将其随机分为对照组和实验组，各100例。对照组采用常规社区护理管理，实验组首先建立社区服务团队，分工开展规范管理。比较两组患者实验前及实验后1年的空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc）、体质指数（BMI）等指标，分析遵医行为和日常生活行为的改变以及患者对糖尿病相关知识的掌握情况和患者遵医率、满意率、幸福指数。结果实验组患者FBG、2hPG、HbAlc和BMI各项指标的平均值分别为（6．9±1．0）mmol／L、（7．3±1．3）mmol／L、（6．4±0．8）％、（21．8±2．6）kg／m^2，均明显低于对照组；实验组日常不良生活习惯有较大改善，对糖尿病相关知识掌握情况良好；实验组患者遵医率、满意度和幸福指数分别为82％、88％、79％，明显高于对照组的74％、71％、65％；两组比较差异均有统计学意义（P〈0．05）。结论社区服务团队对社区糖尿病病人进行规范管理，能提高患者的自我保健意识，对控制2型糖尿病患者的病情有重要意义。

Community service team for standard management of diabetic patients in community

Objective To explore the impact of community service on diabetic patients studying the service team of community medical institutions for the standard management of patients with diabetes. Methods From March 2010 to March 2011, 200 elderly patients with type 2 diabetes treated in community for the first time were selected, and then were randomly divided a experimental group and a control group, 100 cases for each group. The control group received routine community nursing management. Firstly, a community service team was established, then the standard management was divided to carry out in the experimental group. The FBG, 2hPG, HbAlc, and BMI et al. of both groups were compared before and 1 year after the experiment. The changes of the compliance behavior and daily life behavior, the command of diabetic knowledge, the rate of treatment compliance, satisfaction rate, and happiness index were analyzed. Results The FBG, 2hPG, HbAlc, and BMI of the experimental group were （6.9 ± 1.0） mmol/L, （7.3 ± 1.3） mmol/L, （6.4 ± 0.8）%, and （21.8±2.6） kg/m2, which were obviously lower than that of the control group. The experimental group had great improvement in unhealthy living habits and good command of diabetic knowledge. The rate of treatment compliance, satisfaction rate, and happiness index were 82%, 88%, and 79% in the experimental group and 74%, 71%, and 65% in the control group, with statistical differences between the 2 groups （P 〈0.05 ） . Conclusions The standard management of community service team for diabetic patients in community can increase the patients＇ self-care consciousness and play an important role in controlling the conditions of the patients with type 2 diabetes.