摘要
目的采用三甲医院-社区-家庭联动模式对社区冠心病患者进行规范化管理,分析三联模式管理前后的效果变化。方法2022年7—11月选取蚌埠市4个社区的480例冠心病患者,由蚌埠医科大学第一附属医院心血管病专科医生联合社区及患者家庭进行管理。主要观察指标包括管理前后冠心病危险因素、冠心病的知晓率、冠心病二级预防药物使用率、年住院例次、西雅图心绞痛量表评分等。结果联合管理后冠心病患者血压、血糖、血脂、BMI、吸烟率下降,运动人数增加(P<0.05);冠心病知晓率上升(59.79%vs.95.63%,χ^(2)=177.900,P<0.05),冠心病二级预防药物抗血小板药物(90.21%vs.96.88%,χ^(2)=17.656,P<0.05)、调脂类药物(83.13%vs.92.92%,χ^(2)=21.823,P<0.05)、β受体阻滞剂(51.46%vs.85.83%,χ^(2)=131.761,P<0.05)、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂/沙库巴曲缬沙坦(52.29%vs.87.29%,χ^(2)=139.450,P<0.05)使用率上升,年住院例次下降;西雅图心绞痛量表评分改善(P<0.05)。结论三甲医院联合社区及家庭的冠心病规范化管理模式,提高了冠心病患者危险因素的控制,改善了心绞痛发作和生活质量,减少再住院,提升了社区医生冠心病的防治水平,值得在其他慢性病管理中推广应用。
Objective To implement a standardized management model of coronary heart disease(CHD)patients in the community,utilizing a third-class hospital-community-family linkage approach,and to analyze the changes in outcomes before and after this three-mode management.Methods A total of 480 patients with coronary heart disease from July to November 2022 in four communities in Bengbu City were selected.Cardiovascular specialists from the First Affiliated Hospital of Bengbu Medical University,in conjunction with community healthcare providers and patient' s family,man-aged the patients.The main evaluation indicators included changes in risk factors of CHD,awareness rates of CHD,utili-zation rates of secondary prevention drugs,annual hospitalization annual number of hospitalization and scores of Seattle angina questionnaire(SAQ)before and after management.Results The blood pressure,blood glucose,blood lipid,body mass index,smoking rate of patients with coronary heart disease decreased and the number of exercise increased af-ter combined management(P<0.05).The awareness rate of CHD was increased(59.79%vs.95.63%,χ^(2)=177.900,P<0.05).And the utilization rates of antiplatelet drugs(90.21%vs.96.88%,χ^(2)=17.656,P<0.05),lipid-regula-ting drugs(83.13%vs.92.92%,χ^(2)=21.823,P<0.05),β-blockers(51.46%vs.85.83%,χ^(2)=131.761,P<0.05),and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/sacubitril-valsartan(52.29%vs.87.29%,χ^(2)=139.450,P<0.05)increased.The number of annual hospitalizations decreased,and SAQ scores im-proved(P<0.05).Conclusion The standardized management mode of coronary heart disease linking tertiary hospitals,communities,and families improved control of risk factors of CHD patients,reduced attack of angina pectoris,enhanced quality of life,decreased rehospitalization,and elevated the prevention and treatment capabilities of community doctors.This model is worthy promoting for managing other chronic diseases.
作者
宣玲
唐碧
李妙男
谢彩侠
汪利超
王翠香
XUAN Ling;TANG Bi;LI Miaonan;XIE Caixia;WANG Lichao;WANG Cuixiang(Department of Cardiology,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China;不详)
出处
《中华全科医学》
2024年第10期1722-1726,共5页
Chinese Journal of General Practice
基金
安徽省高校人文社会科学研究重点项目(SK2021A0433)
安徽省高校自然科学研究重点项目(2022AH051477)
安徽省临床医学研究转化专项(202304295107020079)
蚌埠市社会科学规划项目(BB22B046)。
关键词
冠心病
慢性病
联合管理
社区卫生服务
Coronary heart disease
Chronic disease
Joint management
Community sanitation service
