【摘要】 目的:评价个案管理对门诊老年2型糖尿病患者血糖控制水平及自我管理能力的干预效果。方法:由内分泌科医生、营养科医生、糖尿病专科护士组成团队合作,采用随机对照试验研究设计,将门诊100例老年2型糖尿病患者随机分为干预组和对照组各50例。干预组接受6个月的个案管理和随访,对照组接受门诊常规指导,定期参加大讲课活动。采用重复测量方差分析,比较干预前、干预6个月后两组患者血糖、糖化血红蛋白(Hb A1c)、血脂和自我管理水平、心理焦虑的各项指标,并进行比较。结果:接受个案管理后,干预组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白、血脂值均较对照组降低(均P<0.01)。干预组在自我管理能力(包括饮食合理、运动锻炼、血糖监测、遵医用药、足部护理知识)认识上的差异有统计学意义(P<0.01),干预组优于对照组。干预组心理焦虑状况较对照组明显降低(P<0.01)。结论:个案管理对门诊老年2型糖尿病患者的血糖代谢水平有一定改善,帮助患者降低血糖,促进患者自我管理行为的建立与提高,掌握健康饮食和科学运动,有效缓解老年糖尿病患者的心理焦虑状况。更多还原

【Abstract】 Objective:To evaluate intervention effect of case management on blood sugar control level and the ability of self-management of elderly outpatient with type 2 diabetes.Methods:100 cases were randomly divided into intervention group(n=50) and control group(n=50) and were treated by a team of endocrinologist,dietician,diabetes specialist nurses.The patients of intervention group accepted the case management and follow-up of 6 months,the patients in control group accepted routine outpatient guidance,big lecture activities on a regular basis.Using repetitive measure analysis of variance,the patients ’ blood sugar,glycosylated hemoglobin(HbA1c),blood lipid and self management level,the indicators of psychological anxiety of all patients were compared between two groups before intervention,after intervention 6 months.Results:After case management,the 2h postprandial blood glucose,fasting glucose,HbA1 c,blood lipid in the intervention group were superior to that of control group significantly(P<0.01),the self management ability(including reasonable diet,exercise and blood sugar monitoring,according to medical medicine,foot care knowledge) and psychological anxiety was also better(P<0.01).Conclusion:The case management for elderly patients with type 2 diabetes can improve metabolism,help to reduce blood sugar,promote self management behavior,master a healthy diet and sports science,ease anxiety effectively.更多还原