摘要
目的 探讨院内非内分泌科室胰岛素泵治疗的多学科协作管理模式,并评价效果。方法 将非内分泌科接受胰岛素泵治疗的患者231例按住院时间分组,2012年7~12月的90例患者为对照组,采用常规会诊、糖尿病教育护士巡视为主的管理模式;2013年1~6月的141例患者为观察组,根据胰岛素泵治疗特点,采用包括内分泌专科医生、糖尿病教育护士、其他非内分泌科室医护人员、营养师等在内的多学科协作管理模式。比较两组胰岛素泵运行及血糖管理方面的差异。结果 观察组胰岛素泵运行中意外事件发生率、血糖达标时间、低血糖发生率显著低于对照组（P〈0.05,P〈0.01）;两组胰岛素泵治疗时间、治疗后空腹血糖水平差异无统计学意义（均P〉0.05）。结论 多学科协作管理模式保证了非内分泌科室胰岛素泵的安全运行,保障了患者的治疗效果。
Objective To explore the multidiseiplinary collaboration for patients receiving insulin therapy outside department of endocrine di- seases and investigate the effectiveness. Methods A total of 231 patients who received insulin pump therapy outside department of endocrine diseases were enrolled and randomly divided into an observation group of 141 members, receiving insulin therapy under the collaborative management of physicians of endocrinology, diabetes nurse specialists, other non-endocrinological specia-lists and nurses, together with nu- tritionists, and a control group of 90 cases, receiving regular consultation and patrol service. Insulin pump operation and glucose control ef- ficiency were compared between the two groups. Results The occurrence rate of accidents during insulin pump therapy and incidence rate of hypoglycemia in the observation group were significantly lower than the control group, while the time needed to achieve targeted glycemic level was significantly shorter in the former group than the latter（P〈0.05, P〈0.01）. However, there were no significant differences in duration of insulin pump therapy and fasting blood glucose after treatment between the two groups. Conclusion Multidisciplinary collabora tion can guarantee safe operation of insulin pump and the effectiveness of the therapy.
基金
卫生部临床重点专科(护理专科)建设项目(财社[2010]305号)
关键词
住院患者
糖尿病
胰岛素泵
持续皮下胰岛素输注
多学科协作管理
hospitalized patients
diabetes mellitus
insulin pump
continuous subcutaneous insulin infusion
multidisciplinary col- laborative management
