基于紧密型医联体的慢阻肺社区防治网络体系建立的临床应用研究  

Clinical application study on the establishment of a network system for COPD prevention and treatment based on close mdical consortiam

作　　者：叶亮[1] 张静[1] 史莹[1] 赵玥铭 邵宏涛[1] 李倩[1] 谷伟[1] 毛山[1] YE Liang;ZHANG Jing;SHI Ying;ZHAO Yue-ming;SHAO Hong-tao;LI Qian;GU Wei;MAO Shan(Department of Respiratory and Critical Care Medicine,Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital),Nanjing,Jiangsu210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)呼吸与危重症医学科

出　　处：《临床肺科杂志》2019年第10期1755-1759,共5页Journal of Clinical Pulmonary Medicine

基　　金：南京市医学科技发展项目(No YKK16129);南京市科技发展计划项目(No 201727003)

摘　　要：目的结合紧密型医联体,初步建立慢阻肺社区防治网络体系,并观察其对慢阻肺综合管理的效果。方法构建紧密型医联体,实验组采用建立好的慢阻肺社区防治网络体系进行综合管理,对照组仅提供基本卫生服务。观察分析两组间的依从性、慢阻肺知晓率、生活质量、肺功能和急性加重等指标,评价该慢阻肺综合防治平台施行价值。结果实验组人群的慢阻肺知晓率、随访率、戒烟率等指标较对照组均明显增高(P<0.05)。实验组患者6分钟步行距离、规范化治疗率较实验前明显增加(P<0.05),且显著高于对照组(P<0.05);急性加重的人数与对照组相比,明显减少(P<0.05);实验组CAT评分较实验前明显降低(P<0.05),且显著低于对照组(P<0.05)。实验组FEV1和FEV1占预计值%与实验前比较,均明显增加(P<0.05)。对照组实验前的FEV1、FEV1占预计值%与实验后相比,差异无统计学意义(P>0.05)。结论本研究的慢阻肺社区防治网络体系有较高的施行价值。Objective To establish a network system for the prevention and treatment of chronic obstructive pulmonary disease(COPD)by combining the close medical consortiam.Methods The established COPD community integrated management system was applied in the experimental group,while in the control group,only basic health services were used.The compliance between the two groups,the awareness of COPD,quality of life,lung function and acute exacerbation were compared to evaluate the implementation value of the COPD community integrated management system.Results After the intervention,the COPD knowledge rates,the follow-up rate and smoking-quitting rate in the experimental group were significantly greater than those in the control group(P<0.05).In the experimental group,6 MWD and standard treatment rate were significantly greater than before(P<0.05)and those in the control group(P<0.05).Acute exacerbation and the CAT score were significantly less in the experimental group than those in the control group(P<0.05).In the experimental group,FEV 1 and FEV 1%Pred were significantly greater than before(P<0.05).The FEV 1 and FEV 1-Pre%of the patients in the control group had no significant difference compared with the post-experimental time(P>0.05).Conclusion The COPD community integrated management system has high implementation value.

关 键 词：慢性阻塞性肺疾病 社区管理 医联体 

分 类 号：R563.9[医药卫生—呼吸系统]