专科-社区医联体模式对居家老龄人员静脉血栓栓塞症的预防效果分析  

To analyze the preventive effect of specialist-community medical alliance model on venous thromboembolism in elderly people at home

作　　者：李松桃[1] 方明亮[2] 曾雪峰 余阗[1] 冯海沜 张小红[1] 王桂芳[1] 程思琪 周雪敏 LI Songtao;FANG Mingliang;ZENG Xuefeng;YU Tian;FENG Haipan;ZHANG Xiaohong;WANG Guifang;CHENG Siqi;ZHOU Xuemin(The 6th People's Hospital of Chengdu,Chengdu 610051,China;The Second People's Hospital of Chengdu,Chengdu 610017,China;Chenghua District Shuangqiaozi Community Health Service Center,Chengdu 610051,China;Chenghua District Fuqing Road Community Health Service Center,Chengdu 610051,China)

机构地区：[1]成都市第六人民医院,四川成都610051 [2]成都市第二人民医院,四川成都610017 [3]成都市成华区双桥子社区卫生服务中心,四川成都610051 [4]成都市成华区府青路社区卫生服务中心,四川成都610051

出　　处：《临床医药实践》2024年第1期3-7,共5页Proceeding of Clinical Medicine

基　　金：2021年度成都市医学科研课题资助项目(课题编号:2021054)。

摘　　要：目的:观察专科-社区医联体模式的开展对居家老龄人员静脉血栓栓塞症(VTE)的预防效果,为预防居家老龄人员发生血栓提供参考方法,以减少居家老龄人员静脉血栓事件的发生。方法:选择2021年9月—2022年12月从呼吸与危重症医学科好转出院回到社区且年龄≥65岁的患者500例,除外因中途退出及失访患者,最终收集到473例患者的完整资料,按随机数字表法分为观察组(239例)和对照组(234例)。观察组由专科-社区医联体医护团队共同参与,给予健康教育、Caprini评分、VTE预防方案的指导及评估;对照组由社区医护团队每月进行常规电话随访。观察两组随访6个月时的VTE相关知识知晓率、VTE发生率以及研究结束时的VTE发生率。结果:观察组随访6个月时的VTE相关知识知晓率明显高于对照组(P<0.05);两组随访6个月时的VTE发生率比较,差异无统计学意义(P>0.05);研究结束时的延续随访观察显示,观察组的VTE发生率低于对照组,差异有统计学意义(P<0.05)。结论:长程的专科-社区医联体管理模式的开展能够减少居家老龄人员静脉血栓事件的发生率。Objective:To explore the preventive effect of specialist-community medical alliance on venous thromboembolism(VTE)in elderly people at home,so as to provide a reference method for the prevention of VTE in elderly people at home,so as to reduce the incidence of VTE in elderly people at home.Methods:A total of 500 patients,aged 65 years or older,who were discharged from respiratory and critical care and returned to the community from September 2021 to December 2022,were selected,the data of 473 patients were collected and randomly divided into observation group(239 cases)and control group(234 cases).The experimental group was jointly participated by the medical team of special-community medical alliance,and was given health education,Caprini score,guidance and evaluation of VTE prevention program.The control group received routine monthly telephone follow-up by community health care team.The awareness rate of VTE-related knowledge,the incidence of VTE at 6 months of follow-up and the incidence of VTE at the end of the study were observed in the two groups.Results:The awareness rate of VTE related knowledge in the observation group was significantly higher than that in the control group after 6 months of follow-up(P<0.05).There was no significant difference in the incidence of VTE between the two groups after 6 months of follow-up(P>0.05).Continuous follow-up observation to the end of the study showed that the incidence of VTE in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion:The long-term specialist-community medical alliance management model can reduce the incidence of venous thrombosis in elderly people at home.

关 键 词：居家老人 静脉血栓 预防 

分 类 号：R543.6[医药卫生—心血管疾病]