品管圈介入干預模式在糖尿病合并冠心病患者中的應用價值探究

許玄 涂娜 王薇 付亞紅 田佩珊 周敏

【摘要】 目的：探究品管圈（quality control circle，QCC）介入干預模式在糖尿病合并冠心病患者中的應用價值。方法：選取2017年5月-2019年8月本院收治的糖尿病合并冠心病患者208例，根據納入及排除標準，排除100例，選取108例患者進行前瞻性研究，隨機分為對照組（n=54）和QCC組（n=54），對照組采用常規干預，觀察組采用品管圈介入干預模式干預，比較兩組干預后并發癥發生率、空腹血糖、餐后2 h血糖、總膽固醇水平及血壓，兩組焦慮自評量表（self-rating anxiety scale，SAS）、抑郁自評量表（self-rating depression scale，SDS）評分及生活質量評分。結果：QCC組各并發癥發生率均顯著低于對照組（P<0.05）;QCC組血糖、總膽固醇、血壓控制均顯著優于對照組，差異均有統計學意義（P<0.05）;QCC組干預后SAS、SDS評分均低于對照組，生活質量評分高于對照組（P<0.05）。結論：QCC介入干預模式能顯著減少DM合并CHD患者并發癥發生率;改善血脂、血糖、血壓、不良情緒，提高患者生活質量，具有極高優越性。

【關鍵詞】 品管圈介入干預模式 糖尿病 冠心病

[Abstract] Objective： To explore the application value of quality control circle （QCC） intervention model in patients with diabetes mellitus （DM） and coronary heart disease （CHD）. Method： A total of 208 patients with DM and CHD admitted to our hospital from May 2017 to August 2019 were selected， according to the inclusion and exclusion criteria， 100 patients were excluded， 108 patients were selected for a prospective study and randomly divided into the control group （n=54） and QCC group （n=54）. The control group received routine intervention， and QCC group used QCC intervention model. The incidence of complications， fasting blood glucose， 2 h postprandial blood glucose， total cholesterol level and blood pressure after intervention， self-rating anxiety scale （SAS）， self-rating depression scale （SDS） scores and quality of life scores of two groups were compared. Result： The incidence of various complications in QCC group were significantly lower than those in the control group （P<0.05）. The blood glucose， total cholesterol， and blood pressure control in QCC group were significantly better than those of the control group， and the differences were statistically significant （P<0.05）. After intervention， the SAS and SDS scores of QCC group were lower than those of the control group， the quality of life scores was significantly higher than that of the control group （P<0.05）. Conclusion： QCC intervention model can significantly reduce the incidence of DM and CHD patients complications， improve blood lipids， blood sugar， blood pressure， bad mood， and improve the quality of life of patients， and has a very high advantage.

[Key words] Quality control circle intervention model Diabetes mellitus Coronary heart disease

First-authors address： The Second Affiliated Hospital of Nanchang University， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2020.27.021

隨著我國人口老齡化加劇及人們生活水平提高，各種老年慢性疾病發病率顯著上升，其中以糖尿病（diabetes mellitus，DM）與冠心病（coronary heart disease，CHD）最為常見，臨床研究指出，CHD是導致DM患者死亡的主要原因之一。此外有研究報道指出，DM是誘發CHD的高危因素之一，同時CHD可加重糖尿病病情，兩者相互關聯，其致殘率、病死率極高[1-2]。文獻[3-4]指出，合理的干預方式能有效改善DM合并CHD患者的治療效果與心理狀態，但目前仍無系統性干預方式。本院于2016年12月成立DM合并CHD干預品管圈心理介入對患者進行干預，并獲得系統性資料。現報道如下。