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目的通过对四城市糖尿病患者早期防治糖尿病肾病(DN)的预防保健服务需要和利用现状的调查,分析糖尿病患者在早期防治中存在的主要问题,为DN早期防治措施的有效实施,改进预防保健服务质量提供科学依据。方法选取2005年杭州、重庆、济南和武汉市7家综合医院和4家社区卫生服务中心门诊的2型糖尿病患者,询问患者发生各类并发症、DN相关代谢指标控制状况和综合治疗情况,并进行体格检查。结果 1 207例糖尿病患者中,64.12%的对象在确诊糖尿病时至少发生1种并发症,36.95%至少发生2种并发症。约一半患者血糖、血压控制不达标,76.2%和86.3%的患者血糖和血压控制不理想,近一半调查对象新发现尿微量白蛋白阳性。多数患者能至少每月测量1次血压(67.02%)。约1/4调查对象实施药物、饮食、运动、糖尿病教育和血糖监测五项治疗措施均为好。每年至少检测1次糖化血红蛋白和尿微量白蛋白的患者为14.41%和23.53%。极少患者定期复查血压、血脂、糖化血红蛋白和尿微量白蛋白四项指标均为好(0.68%)。结论被调查糖尿病患者DN早期防治服务需要和利用间存在较大差距,与指南推荐要求差距大,建议在规范医护人员临床诊疗和预防保健服务的同时,加强患者教育,提高早期防治DN的认知水平和自我管理能力。
Objective To investigate the main problems in the early prevention and treatment of diabetic patients by investigating the needs and utilization status of prevention and care services for diabetic nephropathy (DN) in patients with diabetes mellitus in the four cities in the early stage, and to analyze the main problems existing in the early prevention and treatment of diabetic patients, Quality to provide a scientific basis. Methods Patients with type 2 diabetes who were outpatient in 7 general hospitals and 4 community health service centers in Hangzhou, Chongqing, Jinan and Wuhan in 2005 were asked about the occurrence of various complications and the related control status of DN related metabolic syndrome and the comprehensive treatment. Physical examination. Results Among the 1 207 diabetic patients, 64.12% of the subjects had at least one complication in the diagnosis of diabetes and 36.95% had at least two complications. About half of patients with blood glucose, blood pressure control is not compliance, 76.2% and 86.3% of patients with blood glucose and blood pressure control is not satisfactory, nearly half of the subjects found urine microalbumin-positive. Most patients can measure blood pressure at least once a month (67.02%). About 1/4 of the respondents to implement drugs, diet, exercise, diabetes education and blood glucose monitoring five treatment measures are good. Patients who tested glycosylated hemoglobin and urinary albumin at least once per year were 14.41% and 23.53%, respectively. Very few patients regular review of blood pressure, blood lipid, glycosylated hemoglobin and urinary albumin four indicators are good (0.68%). Conclusion There is a big gap between the needs and utilization of DN in the early-stage diabetic patients under investigation. There is a large gap between the DN service requirements and the guidelines. It is suggested that we should strengthen patient education and improve the cognition of early prevention and treatment of DN while regulating the clinical diagnosis, treatment and prevention of health care services for medical staff Level and self-management skills.