摘要
目的探讨医疗联合体(以下简称医联体)背景下全科医疗服务对缺血性脑卒中恢复期患者的防治效果。方法选择2018—2020年于蚌埠市某三甲医院神经内科入住的首次发作缺血性脑卒中218例作为研究对象,随机化分为观察组和对照组各109例。研究期间失访11例,其中观察组5例,对照组6例。两组患者在三甲医院接受的急性期治疗无差异。观察组患者出院后进入社区,接受3个月的疾病恢复期全科医疗防治服务。对照组患者在恢复期无特殊防治干预,仅给予电话随访和解答疾病疑问。分别比较入社区时、入社区后第1个月、第3个月两组患者的血压、血糖和血脂控制达标率;应用美国国立卫生院神经功能缺损(NIHSS)评分、Rankin修订量表(mRS)评分评估入社区时、入社区后第1个月、第3个月神经功能恢复和日常生活能力;采用自行设计的量表评定在入社区后第3个月两组患者脑卒中知识知晓率和治疗满意度。结果对照组患者在入社区第3个月时血压、血糖和血脂控制达标率分别低于入社区时达标率(P<0.05),也分别低于同时间的观察组达标率(P<0.05);两组患者在入社区后第1个月和第3个月NIHSS评分均下降(P<0.05),而观察组下降更明显(P<0.05);观察组患者在入社区第3个月时mRS评分低于入社区时评分(P<0.05),也低于同时间的对照组评分(P<0.05);观察组患者在入社区第3个月脑卒中知识知晓率高于对照组(P<0.001),且治疗满意度也高于对照组(P<0.001)。结论医联体背景下全科医疗团队为患者提供连续性防治服务,证实可有效控制血压、血糖和血脂达标率,有助于患者神经功能缺损恢复和日常生活能力,提高缺血性脑卒中疾病知识知晓率和治疗满意度,可为其他慢性疾病防治提供借鉴。
Objective To explore the prevention and treatment effect of general practice service in the context of medical consortium on convalescent patients with ischemic stroke(IS).Methods This study selected a total of 218 patients as subjects who got first-episode ischemic stroke and were admitted to the Department of Neurology in a Grade A hospital in Bengbu City from 2018 to 2020.They were randomly divided into an observation group(n=109)and a control group(n=109).During the study,11 patients were lost in follow-up,including 5 in the observation group and 6 in the control group.Patients in the observation group were discharged from the hospital and entered a community hospital to receive 3-month general practice service for prevention and treatment during their convalescence.Patients in the control group had no special intervention of prevention and treatment in the convalescence period,and were only given telephone follow-up and answered questions about the disease.The control rates of blood pressure,blood glucose and blood lipid in two groups were compared at the time of community admission,at 1 month and at 3 months after community admission,respectively.National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(mRS)were adopted to evaluate the neurological recovery and daily living ability of patients at the time of community admission,at 1 month and at 3 months after community admission.A self-designed scale was used to evaluate the patients’awareness rate of IS and their satisfaction with treatment at 3 months after community admission.Results In the control group,the control rates of blood pressure,blood glucose and blood lipid at the 3rd month of community admission were lower than those at the time of community admission(P<0.05),and also lower than those of the observation group at the same time(P<0.05).The NIHSS scores decreased in both groups at 1 month and at 3 months after community admission(P<0.05),and the decrease was more significant in the observation group(P<0.05).The mRS score of
作者
庞雪蕊
刘峰
Pang Xuerui;Liu Feng(Department of General Practice,Bengbu Medical College,Bengbu 233030,Anhui,China)
出处
《右江民族医学院学报》
2021年第3期407-411,共5页
Journal of Youjiang Medical University for Nationalities
基金
安徽省教育厅高校人文社会科学研究项目(SK2020A0359)
蚌埠医学院自然科学基金重点项目(BYKY1812ZD)。
关键词
医疗联合体
全科医学
缺血性脑卒中
分级诊疗
预防
治疗
medical comsortium
general practice
ischemic stroke
tiered diagnosis and treatment
prevention
treatment
