本文選題：社區(qū)　切入點(diǎn)：2型糖尿病　出處：《石河子大學(xué)》2015年碩士論文

【摘要】：目的:通過對(duì)糖尿病患者實(shí)施規(guī)范化綜合防治干預(yù),比較干預(yù)前后及不同頻次的干預(yù)對(duì)血糖指標(biāo)(FPG、2h PG、Hb Alc)、血脂指標(biāo)(TC、TG、HDL-C、LDL-C)、體質(zhì)指標(biāo)(SBP、DBP、BMI)的影響,并分析干預(yù)效果,為今后石河子社區(qū)大面積推廣開展社區(qū)糖尿病規(guī)范化綜合防治干預(yù)提供依據(jù)。方法:采用整群隨機(jī)抽樣方法,在石河子所轄十二個(gè)社區(qū)內(nèi)選取符合納入標(biāo)準(zhǔn)的2型糖尿病患者,隨機(jī)分為常規(guī)干預(yù)組和強(qiáng)化干預(yù)組�；�調(diào)查包括一般情況(年齡、性別、文化程度、職業(yè)、經(jīng)濟(jì)狀況、聯(lián)系方式)、既往史、糖尿病家族史、吸煙史、飲酒史、體格檢查(身高、體重、腰圍、臀圍、SBP、DBP、BMI、WHR)、生活方式、膳食情況、臨床癥狀、治療方案、相關(guān)并發(fā)癥等情況,并檢測(cè)代謝指標(biāo),包括血糖指標(biāo)(FPG、2h PG、Hb Alc)和血脂指標(biāo)(TC、TG、HDL-C、LDL-C)。常規(guī)干預(yù)組于基線調(diào)查后1年內(nèi)每六個(gè)月隨訪,強(qiáng)化干預(yù)組每三個(gè)月隨訪。隨訪干預(yù)內(nèi)容主要為了解患者病情,評(píng)估治療情況;有針對(duì)性地進(jìn)行健康教育;詢問患者飲食結(jié)構(gòu)及運(yùn)動(dòng)量。每周監(jiān)測(cè)血糖次數(shù)及結(jié)果,根據(jù)患者個(gè)人情況調(diào)整治療方案,并抽血檢測(cè)代謝指標(biāo)(同基線)。應(yīng)用Epidata3.02軟件建立數(shù)據(jù)庫(kù)文件并進(jìn)行數(shù)據(jù)錄入,用SPSS17.0查錯(cuò),并進(jìn)行數(shù)據(jù)分析。結(jié)果:1、基線納入研究對(duì)象419例,隨訪一年后,結(jié)局隨訪312例,隨訪率為74.46%,其中,常規(guī)干預(yù)組172例,強(qiáng)化干預(yù)組140例。兩組基線資料齊同(P0.05)。2、石河子市社區(qū)2型糖尿患者干預(yù)前血糖、血脂、血壓達(dá)標(biāo)情況:FPG、2hPG、HbA1c達(dá)標(biāo)率分別為33.33%、25.32%,11.54%;HDL-C、LDL-C、TG達(dá)標(biāo)率分別為87.50%、19.23%、24.68%;血壓達(dá)標(biāo)率為21.47%。3、常規(guī)干預(yù)前后血糖指標(biāo)(FPG、2h PG、Hb Alc)、血脂指標(biāo)(TC、TG、LDL-C)有顯著差異(P0.05);強(qiáng)化干預(yù)前后血糖指標(biāo)(FPG、2h PG、Hb Alc)、血脂指標(biāo)(TC、TG、LDL-C)、體指指標(biāo)(SBP、BMI)明顯降低(P0.05);兩組相比,2h PG、Hb Alc、TG、LDL-C、DBP差異有統(tǒng)計(jì)學(xué)意義(P0.05),隨訪四次效果明顯優(yōu)于兩次。4、常規(guī)干預(yù)組干預(yù)前后2h PG、FPG、Hb Alc達(dá)標(biāo)率較前略有升高,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);強(qiáng)化干預(yù)組干預(yù)前后FPG、2h PG、Hb Alc達(dá)標(biāo)率差異有顯著性(P0.05),兩組之間比較,Hb Alc達(dá)標(biāo)率差異有顯著性(P0.001)。5、常規(guī)干預(yù)前后TC、TG、LDL-C較前降低,差異有統(tǒng)計(jì)意義(P0.05);強(qiáng)化干預(yù)組干預(yù)前后TC、TG、LDL-C差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組間比較,TG、LDL-C差異顯著(P0.05)。6、常規(guī)干預(yù)前后,SBP、DBP、BMI差異無統(tǒng)計(jì)學(xué)意義(P0.05);強(qiáng)化干預(yù)前后,SBP、BMI較前降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組比較,SBP差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:石河子市社區(qū)2型糖尿病患者血糖、血脂、體質(zhì)指標(biāo)控制情況較差。進(jìn)行規(guī)范化綜合防治干預(yù)后,患者的代謝指標(biāo)較前改善,規(guī)范化綜合防治干預(yù)是有效的。隨訪干預(yù)四次效果優(yōu)于兩次。
[Abstract]:Objective: to compare the effects of intervention before and after intervention and at different frequency on blood glucose index (FPG) 2 h PGHb Alcor, serum lipid index (TCX TGG) HDL-CnLDL-CU, physique index SBPnBPU BMI. objective: to compare the effects of intervention before and after intervention in diabetes mellitus patients by standardized comprehensive prevention and treatment, and to analyze the effects of intervention.It provides the basis for promoting and developing the comprehensive prevention and treatment of diabetes mellitus in Shihezi community in the future.Methods: a cluster random sampling method was used to select type 2 diabetes mellitus patients in 12 communities under Shihezi jurisdiction and were randomly divided into routine intervention group and intensive intervention group.The baseline survey included general conditions (age, sex, education, occupation, financial status, contact information, past history, family history of diabetes, smoking history, history of alcohol consumption, physical examination (height, weight, waist circumference, hip circumference, SBPDBP, BMIWHR, lifestyle).Dietary status, clinical symptoms, treatment plan, related complications, and so on. The metabolic indexes, including blood glucose index (FPG) 2 h PGN HbAlc) and blood lipid index (TCU TGN HDL-C), were detected.The routine intervention group was followed up every 6 months after the baseline survey, and the intensive intervention group was followed up every 3 months.The main contents of follow-up intervention were to understand the patient's condition, evaluate the treatment situation, carry out health education in a targeted way, and ask the patient about diet structure and the amount of exercise.The frequency and result of blood glucose were monitored weekly, the treatment plan was adjusted according to the individual condition of the patient, and the metabolic index was detected by blood sampling (same as baseline).Epidata3.02 software is used to build database files and input data, SPSS17.0 is used to check errors, and data analysis is carried out.Results one year after follow-up, 312 cases were followed up, the follow-up rate was 74.46%, 172 cases in routine intervention group and 140 cases in intensive intervention group.The baseline data of the two groups were the same as P0.05An. 2. The blood glucose and blood lipid of patients with type 2 glucose and urine before intervention in community of Shihezi city,The body finger index (SBPU BMI) was significantly lower than that of the control group (P 0.05), and the difference between the two groups was statistically significant (P 0.05), and the follow-up effect of four times was better than that of the two groups. The rate of reaching the standard of Alc in the routine intervention group before and after intervention was slightly higher than that before and after intervention, and the results showed that there was no significant difference between the two groups before and after the intervention, and there was no significant difference between the two groups before and after intervention.However, there was no significant difference between the two groups (P 0.05), and there was significant difference between the two groups before and after intervention (P 0.05), and there was a significant difference between the two groups in reaching the standard rate of HB Alc, and the TCG-LDL-C decreased before and after conventional intervention, and the difference was significant between the two groups before and after the intervention, and the difference was significant between the two groups before and after the intervention, and there was a significant difference between the two groups before and after the intervention, and the difference between the two groups was also significant.The difference was statistically significant (P 0.05), the LDL-C difference of TCU and TGG before and after intervention was statistically significant (P 0.05), the difference of LDL-C between the two groups was significant (P 0.05), and there was no significant difference in BMI between two groups before and after routine intervention (P 0.05), and the BMI of SBP before and after intensive intervention was lower than that before and after intensive intervention.The difference was statistically significant (P 0.05) and the difference of SBP between the two groups was statistically significant (P 0.05).Conclusion: the control of blood glucose, blood lipids and physique index of type 2 diabetes mellitus patients in Shihezi community is poor.After the intervention of standardized comprehensive prevention and treatment, the metabolic index of patients was improved, and standardized comprehensive prevention and treatment intervention was effective.The effect of four follow-up interventions was better than that of two.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

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