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目的 探讨情景式健康教育对2型糖尿病患者血糖控制的影响.方法 将98例2型糖尿病患者按随机数字表法分成试验组和对照组各49例,试验组男19例,女30例,平均年龄(49.6±15.8)岁;对照组男23例,女26例,平均年龄(50.5±14.7)岁.试验组接受情景式教育模式,对照组接受糖尿病常规教育,比较两组患者干预前和干预后1年空腹血糖(FPG)、餐后2h血糖(2 hPG)、糖化血红蛋白(HbAlc)等反映糖尿病疗效的代谢指标以及自护行为能力的变化.采用配对t检验进行统计学分析,以成组t检验进行组间指标的比较.结果 干预前两组FPG、2hPG、HbA1c及自护行为评分差异均无统计学意义;干预1年后,两组FPG、2hPG、HbA1c均较干预前有显著下降,试验组FPG(6.5±1.6)mmol/L、2hPG(7.9±2.0)mmol/L、HbA1 c(6.7±1.2)％都显著低于对照组[(7.8±2.4)mmol/L,(10.6±3.5)mmol/L,(7.5±1.4)％;t=2.71,3.35,2.90;P=0.03,0.02,0.04];试验组饮食控制(22.6±2.8),规律运动(14.8±2.3),遵医嘱服药(15.6±1.6),血糖监测(15.7±1.7),足部护理(17.2±2.1),高低血糖处理(16.9±1.7),患者的各项白护行为能力评分均高于对照组(19.7±3.2,11.9±2.4,13.5±1.6,12.5±2.0,15.6±1.6,14.6±1.9; t=7.36,6.51,5.24,5.07,6.57,6.77;P均＜0.05).结论 情景式健康教育可促进2型糖尿病患者糖尿病自我管理能力提高,改善其血糖控制.

Objective To evaluate the effect of situational health education in glycemic control in type 2 diabetes patients.Methods A total of 98 patients with type 2 diabetes was randomly assigned to the control(n=49)and the study group(n=49).The control group received conventional diabetes education,while the study group received situational health education.Fasting blood glucose(FBG),2-hour plasma glucose (2 hPG),HbAlc and the self-care behaviors were observed at baseline and 1-year after the intervention.Paired t test was used for data analysis.Results FPG,2hPG,HbA1c and self-care behavior scores were not significantly different between the two group at baseline.After 1-year intervention,FPG,2hPG and HbA1c of the two groups were significantly decreased,and FPG,2hPG and HbA1c of the study group were significantly lower than those of the control group(t values were 2.71,3.35 and 2.90,respectively; all P＜ 0.05).In comparison with the control group,self-care scores of the study group were increased(t values were 7.36,6.51,5.24,5.07,6.57 and 6.77,respectively; all P＜0.05).Conclusion Situational health education could improve self-management and glycemic control of type 2 diabetic patients.