新诊疗模式下城乡联合慢性心衰标准化治疗管理效果探索.docVIP

新诊疗模式下城乡联合慢性心衰标准化治疗管理效果探索 　　[摘要] 目的 分析新?\疗模式下城乡联合慢性心衰标准化治疗的管理效果。 方法 选取医院2014年6月～2016年6月收治的慢性心力衰竭患者80例作为研究对象，根据随机数字表法分为两组：患者出院之后，对照组40例给予常规门诊随访，干预组40例使用慢性心衰专用病历，结合计算机数据管理平台，与社区卫生服务中心形成资源共享，联合进行随访管理。随访12个月后，比较两组患者标准化药物使用率、6 min步行距离（6MWT）、再次住院率、心功能改善效果、心血管事件、生存质量。 结果 随访12个月后，干预组LVEF明显高于对照组，血清NT-ProBNP水平明显低于对照组（P0.05）；干预组6MWT明显高于对照组，情绪评分、躯体评分及MLHFQ总分均明显低于对照组（P0.05）；干预组β受体阻滞剂、ACEI/ARB使用率均明显高于对照组（P0.05）；干预组MACE发生率、再住院率及住院时间均明显低于对照组（P0.05）。 结论 新诊疗模式下城乡联合慢性心衰标准化治疗管理模式提高了慢性心力衰竭患者标准化药物使用率、6MWT，改善了生存质量及心功能，降低了再次住院率，为一种有效可行的慢性心力衰竭管理方式。 　　[关键词] 慢性心力衰竭；城乡联合慢性心衰标准化治疗；管理效果；分析 　　[中图分类号] R541.6 [文献标识码] C [文章编号] 1673-9701（2017）30-0138-03 　　[Abstract] Objective To analyze the management effect of standardized treatment of urban and rural combined chronic heart failure under new treatment and diagnosis mode. Methods A total of 80 patients with chronic heart failure from June 2014 to June 2016 who were admitted to hospital were selected as the study subjects. According to the random number table method， the patients were divided into two groups： after the patients were discharged， 40 patients in the control group were given routine outpatient follow-up， and 40 patients in the intervention group were given special medical record of chronic heart failure， combined with computer data management platform， the resource sharing was formed with community health service center， joint follow-up management was performed. After 12 months of follow-up， the standardized drug use rate， 6-minute walking distance（6MWT）， re-hospitalization rate， cardiac function improvement effect， cardiovascular events， and quality of life were compared between the two groups. Results 12 months after follow-up visit， LVEF was significantly higher in the intervention group than that in the control group， and serum NT-ProBNP levels were significantly lower than that in the control group（P 　　[Key words] Chronic heart failure； Standardized treatment of urban and rural combined chronic heart failure； Management effect；