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目的探讨强化社区糖尿病规范化管理模式及疗效。方法选择经过社区规范化管理未得到满意控制的56名糖尿病患者,分为强化管理和普通管理组,进行连续3个月的管理治疗。强化组由社区专家或专科大夫进行一对一督导,增加诊疗频率和就诊时间。普通组由社区责任医生或社区卫生服务专职人员定期体检,填写糖尿病随访记录并给予指导。结果强化组空腹血糖6.92mmol/L,低于普通组8.60mmol/L;餐后2h血糖9.13mmol/L,低于普通组13.51mmol/L;糖化血红蛋白7.65%,低于普通组10.91%;强化组血糖控制良好者60.7%,高于普通组21.4%;糖化血红蛋白控制良好者28.6%,高于普通组7.1%。以上差别均有统计学意义(P<0.001)。强化组药费平均下降120元,普通组药费平均上升50元。结论强化组费用较低且病情控制较好。建议改进现行管理模式从而降低医疗费用。
Objective To explore ways to strengthen standardized diabetes management and efficacy in community. Methods Sixty-six diabetic patients who were not satisfactorily controlled by community standardization were divided into two groups: intensive management and general management group, and managed for three consecutive months. Intensive group by community experts or specialist doctor one-on-one supervision, increase the frequency of treatment and treatment time. General group by the community responsibility doctor or community health service staff regular physical examination, fill in the follow-up records of diabetes and give guidance. Results The fasting blood glucose of the intensive group was 6.92mmol / L, lower than that of the normal group (8.60mmol / L); the plasma glucose of 9.13mmol / L at 2h after meal was lower than that of the normal group (13.51mmol / L) The group with good glycemic control was 60.7%, higher than the common group 21.4%; HbAlccontrol well 28.6%, higher than the ordinary group 7.1%. The above differences were statistically significant (P <0.001). Intensive drug costs decreased by 120 yuan on average, average drug costs increased by 50 yuan. Conclusion The intensive group has lower cost and better disease control. It is recommended to improve the current management model to reduce medical costs.