基于医联体平台的社区卫生服务中心心房颤动抗凝管理模式探索  

Exploration of Anticoagulation Management Mode of Atrial Fibrillation in Community Health Service Center Based on Medical Treatment Combination Platform

作　　者：许珊珊 沈慧 闫珊 左惠琴 王新华[2] 陈国良 XU Shanshan;SHEN Hui;YAN Shan;ZUO Huiqin;WANG Xinhua;CHEN Guoliang(Huamu Community Health Service Center in Pudong New Area,Shanghai,China 201204;Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China 200126)

机构地区：[1]上海市浦东新区花木社区卫生服务中心,上海201204 [2]上海交通大学医学院附属仁济医院,上海200126

出　　处：《中国药业》2024年第6期24-28,共5页China Pharmaceuticals

基　　金：上海市浦东新区卫生健康委员会卫生科技项目[PW2020B-15]。

摘　　要：目的进一步规范并优化社区卫生服务中心心房颤动(简称房颤)患者的抗凝治疗。方法从上海市浦东新区花木社区卫生服务中心角度出发,总结其与其医疗联合体(简称医联体)上级单位上海交通大学医学院附属仁济医院联合开展抗凝管理的经验,实现规范化、同质化管理的方式。结果该社区卫生服务中心从优化配套服务措施,建立抗凝管理团队,明确抗凝管理路径,加强抗凝团队培训与考核4个方面对房颤抗凝管理的高效开展进行了探索。患者的抗凝药物使用率提高了16.49%,抗凝依从率为83.78%;社区居民房颤常识得分提高了(9.56±1.85)分,房颤患者抗凝知识得分提高了(10.05±2.42)分。74例接受抗凝治疗的非瓣膜性房颤患者CHA_(2)DS_(2)-VASc量表评分为(3.26±1.19)分,HAS-BLED量表评分为(1.35±0.71)分,无新发脑卒中和血栓栓塞事件发生。结论该区卫生服务中心房颤抗凝管理模式(基于医联体)取得了一定的成效,可为各区域医联体平台优化抗凝管理提供参考。但仍需在实践中不断优化。Objective To standardize and optimize the anticoagulation therapy for patients with atrial fibrillation in community health service center.Methods From the perspective of the Huamu Community Health Service Center in Pudong New Area,Shanghai,the experience of its anticoagulation management jointly carried out with the Renji Hospital,Shanghai Jiao Tong University School of Medicine,its supervisor of the medical treatment combination,was summarized to realize the standardized and homogeneous management.Results The efficient implementation of anticoagulation management for atrial fibrillation was explored by the community health service center from four aspects,including optimizing the supporting service,establishing an anticoagulation management team,clarifying the anticoagulation management paths,and strengthening the training and assessment of anticoagulation team.The use rate of anticoagulant drugs in patients increased by 16.49%,with the adherence rate of anticoagulation of 83.78%.The score of community residents on atrial fibrillation knowledge increased by(9.56±1.85)points,and the score of patients with atrial fibrillation on anticoagulation knowledge increased by(10.05±2.42)points.Seventy-four patients with non-valvular atrial fibrillation received anticoagulation treatment had a CHA_(2)DS_(2)-VASc score of(3.26±1.19)points and a HAS-BLED score of(1.35±0.71)points,and no new stroke or thromboembolism event occurred.Conclusion The anticoagulation management mode of atrial fibrillation in community health service center based on medical treatment combination is effective,which can provide a reference for optimizing anticoagulation management on medical treatment combination platforms in various regions.However,it still needs to be continuously optimized in practice.

关 键 词：心房颤动 医疗联合体 抗凝管理 社区卫生服务中心 

分 类 号：R95[医药卫生—药学]