在社区医疗工作中实施冠心病三级预防的问题分析  

Analysis of the problems in the implementation of three-level prevention of coronary disease in community medical treatment

作　　者：徐萧 刘炜 肖玉芬[1] Xu Xiao;Liu Wei;Xiao Yufen(Department of General Practice, The Fifth Affiliated Hospital of Kunming Medical University(Diannan Central Hospital of Honghe State), Gejiu, Yunnan 661000, China)

机构地区：[1]昆明医科大学第五附属医院,红河州滇南中心医院全科,云南省个旧661000

出　　处：《中国基层医药》2019年第5期638-640,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：以"冠心病三级预防"为检索词,在《中国知网期刊数据库》中检索2014-2018年国内医药文献,对社区医疗中冠心病三级预防的实施情况、存在的问题进行分析。存在的问题主要有:(1)冠心病高危患者对疾病的认知水平有限,不能及时就诊。(2)社区医务人员对辖区内冠心病的高危人群不能定期进行规范地筛查。(3)患者对规范化三级预防治疗的方案及必要性不能完全理解。(4)规范化三级预防的经济成本较高,治疗的依从性低。(5)社区全科医生与心血管病专科医生对冠心病三级预防认知不能同质化。建议:(1)在社区医疗中,要规范实施冠心病三级预防治疗,除了应重点关注患者的健康教育问题、定期筛查高危患者外,还应指定心血管专科医生定期对社区医生进行专业培训。(2)政府层面也可对因为经济原因、不能坚持规范化治疗的低收入患者,给予适当的政策帮扶。The " three-level prevention of coronary heart disease" was selected as the search term, the domestic medical literature from 2014 to 2018 was searched in the China Knowledge Network Journal Database, and the implementation and problems of the third-level prevention of coronary heart disease in community medical treatment was analyzed.The main problems are:(1)high-risk patients with coronary heart disease have limited knowledge of the disease and cannot be treated in time;(2)community medical personnel cannot regularly and regularly screen the high-risk groups of coronary heart disease in the area;(3)patients cannot fully understand the scheme and necessity of standardized tertiary prevention and treatment;(4)the economic cost of standardized third-level prevention is high, and the compliance of treatment is low;(5)community general practitioners and cardiovascular specialists cannot homogenize the cognitive knowledge of coronary heart disease.Recommendations:(1)In community health care, it is necessary to standardize the implementation of tertiary prevention and treatment of coronary heart disease.In addition to focusing on the health education of patients and regularly screening high-risk patients, cardiovascular specialists should also be designated to regularly conduct professional training for community doctors;(2)At the government level, appropriate policy assistance can be given to low-income patients who are unable to adhere to standardized treatment for economic reasons.

关 键 词：冠状动脉疾病 高血压 糖尿病 高脂血症 危险因素 社区卫生服务 预防 问题解决 

分 类 号：R541.4[医药卫生—心血管疾病]