糖尿病视网膜病变社区筛查对其依从性的影响解析.doc

社区干预对糖尿病视网膜病变患者治疗的依从性及效果的影响 周源源 徐哲 伍雪云 刘玉琼 李柏坚 丁毅 （桂林市人民医院，广西 桂林 541002） 摘要 目的 观察社区干预对并发糖尿病视网膜病变（diabetic retinopathy, DR）的糖尿病（diabetes mellitus，DM）患者治疗的依从性及效果的影响。 方法 从678例Ⅱ型DM患者中筛查、确诊DR 148例，随机分为干预组和对照组各74例，DR对照组常规健康档案慢性病管理，干预组在对照组基础上进行社区干预，包括社区医护团队和眼科、内分泌科专科医师联合干预、定期检查眼底、签订家庭签约式服务及心理干预，观察2年，评价两组的依从性和干预效果。结果 干预组DM患者的依从性增加，血糖控制率比对照组普遍提高，两组比较差异有统计学意义（P＜0.05），干预组视网膜病变发展缓于对照组，两组比较具有统计学意义（P＜0.05）。结论社区干预能提高辖区DM患者治疗依从性及血糖控制率，对及早发现DR、保护视力、控制血糖、提高生存质量有积极的作用。 关键词 糖尿病；糖尿病视网膜病变；社区干预；依从性 基金项目:桂林市科技攻关课题（项目编号5-1） The Effect of Community Intervention on Adherence and Efficacy of Diabetic Retinopathy Patients Yuan-yuan Zhou,Zhe Xu, Xue-yun Wu,Yu-qiong Liu,Bo-jian Li,Yi Ding Peoples hospital of guilin(guangxi guilin 541002) Abstract Objective To observe the effect of community intervention on adherence and efficacy of diabetic retinopathy patients.Method 148 diabetic retinopathy patients screening from 678 type Ⅱ DM patients in guilin xiangshan area randomly divided into intervention group and control group.DR control group managed by chronic disease records,DR Intervention group managed by community intervation including concerted interventions by community health care team and ophthalmology, endocrinologist specialist, regularly checking the fundus, signing a family type service and psychological intervention.Then the intervention efficacy and adherence of the two groups were evaluated. Result Compliance of regular examination and effectively control blood sugar of DR intervention group were more increased than control group,and two groups compare the difference was statistically significant (P 0.05),there were statistical difference between two groups on fundus lesions develop (P 0.05).Conclusion Community intervention on DM patients can improve treatment compliance and effective control of blood sugar,helping to diagnosis DR early , protecting vision, controlling blood sugar, improving the quality of life. Key Words: diabetes mellitus;diabetic ret