Abstract:

Objective　To explore the application effect of medical conjunctive hierarchical diagnosis and treatment in the hospital-community management for diabetic foot patients. Methods　A total of 100 diabetic foot patients from Xinxiang Central Hospital from January 2020 to January 2023 were selected as the study objects for the prospective study, and were divided into a control group and an observation group according to the random number table method, with 50 cases in each group. In the control group, 34 males and 16 females, aged 55-74 (64.05±3.41) years, were given routine nursing. In the observation group, 33 males and 17 females, aged 54-73 (64.01±3.06) years, were given medical conjunctive hierarchical diagnosis and treatment nursing model. The Wagner grade, diabetic foot risk factors, and Diabetic Foot Self-Care Questionnaire of the University of Malaga (DFSQ-UMA) score were compared between the two groups. Statistical methods used were t test and χ² test. Results　After intervention, the proportion of Wagner grade 0, 1, and 2 in the observation group was higher than that in the control group [96% (48/50) vs. 86.00% (43/50)], but the proportion of Wagner grade 3, 4, and 5 was lower than that in the control group [4.00% (2/50) vs. 14.00% (7/50)], with a statistically significant difference (χ²=5.13, P<0.05). The scores of diabetic foot risk factor scale in both groups after intervention were higher than those before intervention, and that in the control group was higher than that in the observation group [(38.52±6.17) points vs. (35.41±5.23) points], with a statistically significant difference (t=2.28, P<0.05). After intervention, the scores of personal care, foot care, and wearing shoes and socks of the DFAQ-UMA in both groups were higher than those before intervention, and those in the observation group were higher than those in the control group [(4.65±1.03) points vs. (3.82±1.09) points, (3.09±0.85) points vs. (2.56±0.90) points, (1.65±0.61) points vs. (1.29±0.64) points], with statistically significant differences (t=3.91, 3.03, and 2.88, all P<0.05). Conclusion　The use of medical conjunctive hierarchical diagnosis and treatment management for diabetic foot patients can reduce the high risk factors and enhance their level of prognostic self-care, which is worthy of promotion and reference in every clinic.

Key words:

Diabetic foot, Hierarchical diagnosis and treatment, Medical alliance, Hospital-community management, Application effect

摘要：

目的　探究医联体分级诊疗在糖尿病足患者医院-社区管理中的应用效果。方法　选择2020年1月至2023年1月新乡市中心医院收取的100例糖尿病足患者进行前瞻性研究，按照随机数字表法分为对照组和观察组，各50例。对照组男34例，女16例，年龄55～74（64.05±3.41）岁，采用常规护理；观察组男33例，女17例，年龄54～73（64.01±3.06）岁，应用医联体分级诊疗护理模式。对比两组患者Wagner分级、糖尿病足危险因素以及马拉加大学糖尿病足自我护理问卷（DFSQ-UMA）评分。统计学方法采用t检验、χ²检验。结果　干预后，观察组患者Wagner分级中的0、1、2级分级比例较对照组高［96%（48/50）比86.00%（43/50）］，3、4、5级分级比例较对照组低［4.00%（2/50）比14.00%（7/50）］，差异有统计学意义（χ²=5.13，P<0.05）。两组患者干预后糖尿病足危险因素量表评分均高于干预前，且对照组高于观察组［（38.52±6.17）分比（35.41±5.23）分］，差异有统计学意义（t=2.28，P<0.05）。两组患者干预后DFAQ-UMA中的个人照顾、足部护理、鞋袜穿着评分均高于干预前，且观察组均高于对照组［（4.65±1.03）分比（3.82±1.09）分、（3.09±0.85）分比（2.56±0.90）分、（1.65±0.61）分比（1.29±0.64）分］，差异均有统计学意义（t=3.91、3.03、2.88，均P<0.05）。结论　针对糖尿病足患者采取医联体分级诊疗管理，可降低患者的高危因素，提升患者预后自我护理水平，值得临床推广借鉴。

关键词:

糖尿病足, 分级诊疗, 医联体, 医院-社区管理, 应用效果