日住一体化管理模式在急性髓系白血病完全缓解后治疗中的应用研究  

A study on the application of an integrated day and residential management model after complete remission of acute myeloid leukaemia

作　　者：王静 许芳 陈斌 胡宏 刘宜平 苏静 梁效功 王书 WANG Jing;XU Fang;CHEN Bin;HU Hong;LIU Yiping;SU Jing;LIANG Xiaogong;WANG Shu(Department of Hematology,Mianyang Central Hospital,School of Medicine,University of E lectronic Science and Technology of China,Mianyang,Sichuan,621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院绵阳市中心医院血液内科,四川绵阳621000

出　　处：《临床血液学杂志》2025年第3期232-239,共8页Journal of Clinical Hematology

基　　金：绵阳市中心医院院级课题(No:2023YJ013);自贡市哲学社会重点研究基地“健康人文研究中心”基金项目(No:JKRWY22-19)。

摘　　要：目的:探讨日住一体化管理模式在急性髓系白血病(AML)完全缓解后维持治疗中的应用效果,并对比分析日间治疗与住院治疗的临床特征。方法:选取2022年1月—2024年8月在绵阳市中心医院血液内科接受完全缓解后维持治疗的AML患者作为研究对象,根据是否入住日间病房,将其分为日间组(n=33)与住院组(n=30)。通过自制的一般资料问卷和白血病治疗功能评估量表(FACT-Leu)对患者进行调查,采用单因素分析比较两组间的差异,并进行描述性统计分析。结果:①单因素分析显示:与住院组相比,日间组患者的年龄偏大,吸烟史、居住于市区、对强化疗不耐受的患者占比更高,接受维奈克拉和阿扎胞苷联合方案(VA)或去甲基化维持方案的比例也更高,且依从性更佳,Barthel指数、焦虑抑郁评分均更高,Caprini评分、Morse评分更低,留置中心静脉导管、日均治疗费用更低,发生出血的比例更低,次数更少(P<0.05),两组间ECOG(P=0.016)、静脉抗感染次数(P<0.001)比较,差异有统计学意义。②描述性统计显示,完全缓解后AML患者的总体生活质量评分为(134.91±24.51)分。结论:日住一体化管理模式在完全缓解后的AML维持治疗中,不仅保证了治疗效果,降低了日均治疗费用,还显著提高了患者的依从性和生活质量。该模式有助于落实双向转诊,推进紧密医共体的建立,最终实现患者、医院和社会的三方共赢。该管理模式具有广泛推广和应用的潜力。Objective:To explore the application effects of the integrated day and residential management model in the maintenance treatment of acute myeloid leukemia(AML)after complete remission,and to compare the clinical features and economic value of day care and inpatient care modes.Methods:AML patients who received maintenance therapy after complete remission in the Department of Hematology of Mianyang Central Hospital between January 2022and August 2024were included.They were divided into day-care group and inpatient group according to whether they were admitted to the day care unit or not.A self-administered general information questionnaire and the functional assessment of leukemia therapy scale(FACT-Leu)were administered to the patients through the collection of clinical data,and the differences between the two groups were compared using one-way analysis of variance,and descriptive statistical analysis was performed.Results:①Univariate analysis showed that compared with the inpatient group,patients in the day care group were older,lived permanently in the city,had a higher percentage of patients intolerant of intense chemotherapy,had a higher percentage of patients receiving maintenance regimens with venetoclax+azacitidine(VA)or demethylation,and had better compliance;the Barthel index and anxiety-depression scores were higher,and the Caprini and Morse scores were lower,and more had central venous catheters,lower average daily treatment cost,lower percentage and less frequent occurrence of bleeding(P<0.05),and statistically significant differences in ECOG(P=0.016),and the number of intravenous antiinfections(P<0.001)between the two groups.②Descriptive statistical analysis showed that the overall quality of life score for patients with AML in complete remission was(134.91±24.51)points.Conclusion:The integrated daily and residential management mode in the maintenance treatment of AML after achieving complete remission not only guaranteed the efficacy of treatment and lowered the average daily treatment cost,but

关 键 词：日住一体化 急性髓系白血病 完全缓解 日间治疗 

分 类 号：R733.71[医药卫生—肿瘤]