摘要
目的评价"3+X"家庭医生团队服务对老年糖尿病患者健康管理的效果。方法以苏州高新区狮山街道参与社区体检的70~80岁糖尿病患者为研究对象,按照是否加入"3+X"家庭医生签约管理项目分为管理组和对照组,管理组实行"3+X"家庭医生团队服务持续干预2年。采用问卷调查一般人口学信息、身高、体重、腰围、糖尿病家族史、心脑血管病及肾脏疾病的既往史和用药史;对干预前后的心率、吸烟和饮酒状况、血压值、血糖(Glu)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和血糖控制率等进行比较。结果管理组523例,对照组157例,管理组平均年龄(70.9±4.5)岁,低于对照组(72.9±5.9)岁,差异有统计学意义(P<0.05)。基线调查,除管理组心率[(74.39±14.41)/min]低于对照组[(71.83±11.91)/min],差异有统计学意义(P<0.05)外,两组BMI、Glu、TG、TC、HDL-C、LDL-C水平和吸烟率、饮酒率等指标差异均无统计学意义(P值均>0.05)。管理后,与基线水平相比,首次体检对照组Glu、TG和LDL-C水平均升高,管理组心率、HDL-C水平上升、Glu降低;且管理组Glu、TG和LDL-C均低于对照组,血糖控制率(34.23%)高于对照组(4.46%);以上差异均有统计学意义(P值均<0.05)。结论 "3+X"家庭医生团队项目对社区老年糖尿病患者的血糖与血脂干预效果较好。
Objective To evaluate the effect of "3+X" family doctor team service on health management of elderly patients with diabetes.Methods Diabetes patients aged 70 to 80 years who participated in community physical examination in Shishan community of Suzhou High-Tech district were divided into management group and control group according to whether enrolling in the "3+X" family doctor contract management project.The management group were intervened by "3+X" family doctor team service for 2 years.Demographic information,height,weight,waist circumference,family history of diabetes,previous history of cardiovascular/cerebrovascular diseases and renal diseases together with medication history of subjects were investigated by questionnaires.The heart rate,smoking and drinking status,blood pressure,blood glucose(GLU),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and blood glucose control rate of subjects were compared before and after intervention.Results There were 523 cases in the management group and 157 cases in the control group.The average age of the subjects in management group was(70.9±4.5)years old,which was younger than that of the control group[(72.9±5.9)years old],the difference was statistically significant(P<0.05).In the baseline survey,except for the heart rate of the management group[(74.39±14.41)/min]was lower than that of the control group[(71.83±11.91)/min],the difference was statistically significant(P<0.05);there were no significant differences for BMI,GLU,TG,TC,HDL-C,LDL-C,smoking rate and drinking rate between the two groups(all P>0.05).After intervention,the first physical examination results were compared with baseline survey results,the levels of GLU,TG and LDL-C of subjects increased in the control group,while heart rate and HDL-C increased and GLU of subjects decreased in the management group;the GLU,TG and LDL-C in the management group were lower than those in the control group,and the blood glucose control rate(34.23%)was higher than that in the control group(4.46%);all above differences were statistically significant(all P<0.05).Conclusion The "3+X" family doctor team project has a good effect on the control of blood sugar and lipids levels among elderly diabetic patients in the community.
作者
谷红波
俞浩
孙宏鹏
董昊裕
王从菊
GU Hong-bo;YU Hao;SUN Hong-peng;DONG Hao-yu;WANG Cong-ju(Shishan Community Health Service Center,Jiangsu Suzhou 215011,China;不详)
出处
《江苏预防医学》
CAS
2021年第3期264-266,共3页
Jiangsu Journal of Preventive Medicine
基金
苏州高新区医疗卫生科技计划项目(2016F006)。
关键词
糖尿病
家庭医生签约
血糖
血脂
随访干预
Diabetes
Family doctor contract
Blood glucose
Blood lipid
Follow-up intervention
