医联体信息管理平台在社区2型糖尿病患者血糖自我监测管理中的应用

doi:10.3761/j.issn.0254-1769.2023.24.001

摘要/Abstract

摘要：

目的应用基于医联体的自我血糖监测信息管理平台管理社区2型糖尿病患者，探讨对提高其自我血糖监测处方执行率和血糖控制水平的影响。方法采用便利抽样法，选取2021年4月—2023年4月北京市某三级甲等医院医联体内某社区的2型糖尿病患者121例，采用随机数字法分为试验组61例和对照组60例，试验组使用基于医联体以护士为主体的自我血糖监测信息管理平台进行管理，对照组实施常规血糖管理。在第1周及第12周对两组患者糖化血红蛋白、空腹血糖、餐后2 h血糖、自我血糖监测处方完成情况等进行测评及分析。结果试验组61例、对照组58例完成随访。两组患者基线时（第1周）糖化血红蛋白水平差异无统计学意义（P=0.117），第12周时试验组糖化血红蛋白下降达标率与对照组相比，差异有统计学意义（P=0.014）。试验组自我空腹血糖监测次数及其他各时间点血糖监测总次数多于对照组（P<0.001）；试验组自我血糖监测处方执行率优于对照组（P<0.001）。结论构建自我血糖监测信息管理平台管理社区2型糖尿病患者，让患者掌握并执行以护士为主体的医联体团队制订的个性化血糖监测处方，有利于提高其血糖监测频率，改善血糖控制水平。

关键词: 信息管理, 糖尿病, 自我血糖监测, 社区保健护理

Abstract:

Objective To study the effect of self-monitoring of blood glucose information management platform based on the medical consortium on the level of blood glucose control by improving the implementation rate of self-monitoring of blood glucose prescriptions for type 2 diabetes patients in the community. Methods A convenient sampling method was used to select 121 patients with type 2 diabetes from April 2021 to April 2023 who were enrolled in a community of a tertiary hospital medical consortium in Beijing. They were randomly divided into 61 patients in an experimental group and 60 patients in a control group. The control group received routine blood glucose monitoring and guidance education，while the experimental group was managed by a self-monitoring of blood glucose information management platform based on the medical consortium with nurses as the main body. Glycated hemoglobin，glucose test，fasting blood sugar，blood glucose 2 hours after meal，and the completion of self blood glucose monitoring prescriptions were evaluated and analyzed in the first week and the twelfth week of the 2 groups. Results 61 cases in the experimental group and 58 cases in the control group completed the follow-up，and the patients who completed the follow-up were analyzed. There was no statistically significant difference in glycated hemoglobin between the 2 groups at baseline（P=0.117）. After 12 weeks，the reduction standard-reaching rate in glycated hemoglobin in the experimental group was significantly different from that in the control group（P=0.014）. The number of self-monitoring of fasting blood glucose and the total number of other time periods in experimental group were significantly higher than those in the control group（P<0.001）；the implementation rate of self-monitoring prescription in the experimental group was better than that in the control group（P<0.001）. Conclusion A self blood glucose monitoring information platform was built to manage community type 2 diabetes patients，so that patients can master and implement the personalized blood glucose monitoring prescription formulated by the medical union team with nurses as the main body，and it is conducive to improving the frequency of blood glucose monitoring and the level of blood glucose control of diabetes patients.

Key words: Information Management, Diabetes, Self-Monitoring Blood Glucose, Community Health Nursing

武全莹, 郭立新, 孙超, 潘琦, 周起, 于淑一. 医联体信息管理平台在社区2型糖尿病患者血糖自我监测管理中的应用[J]. 中华护理杂志, 2023, 58(24): 2949-2956.

WU Quanying, GUO Lixin, SUN Chao, PAN Qi, ZHOU Qi, YU Shuyi. Application of self-monitoring of blood glucose information management platform based on medical consortium in community patients with type 2 diabetes[J]. Chinese Journal of Nursing, 2023, 58(24): 2949-2956.

图/表 3

表1 两组患者一般资料比较

Table 1 Comparison of general data of 2 groups of diabetes patients

表2 两组12周内自我血糖监测次数及处方执行率比较[M（P25，P75）]

Table 2 Comparison of SMBG（record） frequency and SMBG prescription execution rate within 12 weeks between 2 groups of patients[M（P25，P75）]

表3 两组干预前后糖化血红蛋白值差异比较

Table 3 Comparison of the difference of glycated hemoglobin between the first week and the twelfth week of the 2 groups

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