陈黎, 鹿文英. 2型糖尿病临床路径式管理探索[J]. 上海预防医学, 2013, 25(6): 302-305.
引用本文: 陈黎, 鹿文英. 2型糖尿病临床路径式管理探索[J]. 上海预防医学, 2013, 25(6): 302-305.
CHEN Li, LU Wen-ying. Clinical pathway management of type 2 diabetes[J]. Shanghai Journal of Preventive Medicine, 2013, 25(6): 302-305.
Citation: CHEN Li, LU Wen-ying. Clinical pathway management of type 2 diabetes[J]. Shanghai Journal of Preventive Medicine, 2013, 25(6): 302-305.

2型糖尿病临床路径式管理探索

Clinical pathway management of type 2 diabetes

  • 摘要: 目的评价临床路径的方法在社区2型糖尿病管理中的效果。方法将"临床路径"理念引入社区糖尿病管理,使2型糖尿病的防控及诊疗质量实现规范化、信息化,以空腹血糖、糖化血红蛋白等糖尿病主要指标控制水平作效果评价。结果空腹血糖均值和收缩压2012年比2011年平均有所降低,分别降低(0.28±2.72)mmol/L和(1.58±14.92)mmHg(P均<0.05)。分层分析后发现,糖化血红蛋白高于正常者,其空腹血糖均值和糖化血红蛋白均值2012年与2011年比较,分别降低(1.49±3.02)%和(1.22±1.56)%(P均<0.05)。而糖化血红蛋白均值正常者,空腹血糖均值和糖化血红蛋白均值2012年与2011年比较,分别升高(0.38±2.29)mmol/L和(0.63±1.23)%(P均<0.05)。结论应用临床路径式管理对社区2型糖尿病的达标管理及成本控制起到积极的推动作用,为全科医师进行糖尿病患者的日常健康管理提供重要的信息辅助。

     

    Abstract: Objective To assess the effect of the clinical pathway used in community management of type 2 diabetes. Methods The ‘clinical pathway’ idea was introduced into community management of diabetes, with the aim to realizing standardization and informationization for prevention and control of diabetes. And the effect evaluation was done on the control level of main diabetes indexes as fasting blood glucose,HbA1c and others. Results The mean fasting blood glucose and systolic blood pressure in 2012 were decreased as compared with those in 2011, being reduced by (0.28±2.72)/L(P<0.05) and (1.58±1.58) mmHg(P< 0.05),respectively. But the mean diastolic blood pressure in 2012 was higher by (1.25±8.88) mmHg (P< 0.05) than that in 2011. Stratified analysis showed the patients with HbA1c higher than normal had the mean fasting blood glucose and HbA1c in 2012 lower than that in 2011, lower by (1.49±3.02) mmol/L(P<0.05) and (1.22±1.56) mmol/L(P<0.05).But the patients with normal HbA1c had the mean fasting blood glucose and HbA1c in 2012 higher than that in 2011,higher by (0.38±2.29) mmol/L(P<0.05) and (0.63±1.23) mmol/L(P<0.05). It had statistical significance. The rest of the indicators did not have statistical significance for two years(P>0.05). Conclusion Clinical pathway plays a positive role in the community standard management of diabetes and cost control, providing important assistance for GP in their day-to-day health management for diabetics.

     

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