整合医学模式治疗老年冠心病合并心理疾病患者的效果  

The effect of integrated medical model on elderly patients with coronary heart disease complicated with mental illness

作　　者：余娟 赵明中 李慧敏 刘莉娟 张丽苹 禹香菊 Yu Juan;Zhao Mingzhong;Li Huimin;Liu Lijuan;Zhang Liping;Yu Xiangju(Heart Center,the Ninth People＇s Hospital of Zhengzhou,Zhengzhou 450053,China;Department of Laboratory Medicine)

机构地区：[1]郑州市第九人民医院心脏中心,河南郑州450053 [2]郑州市第九人民医院检验科,河南郑州450053

出　　处：《河南医学研究》2018年第11期1923-1926,共4页Henan Medical Research

基　　金：河南省科技攻关项目(201403243);河南省郑州市金水区科技攻关项目(20143344)

摘　　要：目的探讨整合医学模式治疗老年冠心病合并心理疾病患者的效果。方法选取2014年6月至2017年5月在郑州市第九人民医院住院的1 214例老年冠心病患者,调查患者心理疾病的发生情况。将合并心理疾病的患者按随机数表法分为干预组和对照组,给予对照组心内科常规药物治疗,给予干预组多学科整合团队综合治疗。比较两组患者平均住院时间及住院期间费用,随访1 a,观察两组患者再住院、全因死亡情况。结果冠心病合并精神心理问题737例(60.7%)。两组基础资料差异无统计学意义(P>0.05)。干预组平均住院天数较对照组短,平均医疗费用较对照组低,差异有统计学意义(P<0.05)。干预组全因死亡率低于对照组,心绞痛、非致死性心肌梗死、非致死性脑卒中及心力衰竭事件发生率、再住院率低于对照组,差异有统计学意义(P<0.05)。结论老年冠心病患者合并心理疾病发生率较高,多学科团队联合查房诊疗模式可以使住院老年冠心病合并心理疾病患者获益。Objective To explore the effect of integrated medical model in the treatment of elderly patients with coronary heart disease complicated with mental illness. Methods A total of1 214 elderly patients with coronary heart disease admitted to the Ninth People＇s Hospital of Zhengzhou from June of 2014 to May of 2017 were selected to investigate the occurrence of mental illness. The patients with mental illness were divided into intervention group and control group according to the random number table method. The control group was treated with routine medicine for cardiology,and the intervention group was treated with multidisciplinary integrated team. The average length of hospital stay and the cost of hospitalization were compared between the two groups. The rehospitalization and all-cause mortality were observed after 1 year. Results There were 737 cases（ 60. 7%） of mental problems associated with coronary heart disease. There was no significant difference in the basic data between the two groups（ P〉 0. 05）. The average length of hospital stay in the intervention group was shorter than that in the control group,and the average medical cost was lower than that in the control group,and the difference was statistically significant（ P〈0. 05）. The all-cause mortality rate and the incidence of angina pectoris,non-fatal myocardial infarction,non-fatal stroke and heart failure in the intervention group were lower than that in the control group,and the difference was statistically significant（ P〈0. 05）.Conclusion The incidence of mental illness in elderly patients with coronary heart disease is high,and the multi-disciplinary team combined with ward rounds of diagnosis and treatment can benefit hospitalized elderly patients with coronary heart disease and mental illness.

关 键 词：老年人 冠心病 心理疾病 多学科整合团队 

分 类 号：R749[医药卫生—神经病学与精神病学]