基层医院慢性心力衰竭疾病管理

Experience of Disease Management about Chronic Heart Failure in Primary Hospital

目的:探讨基层医院慢性心力衰竭(CHF)疾病管理的方法和途径。方法:通过对144例CHF疾病管理,开展健康教育、系统指导、定期随访,填写自理能力量表、回访登记表,定期评估自理能力与药物规范使用率的变化。结果:CHF患者管理后各时间段的自理能力与药物规范使用率均有明显的提高,且连续保持较高水平。结论:宣传普及CHF防治知识,开展患者健康教育,设立CHF门诊系统指导和定期随访是CHF疾病管理的有效途径。

Objective：Study the methods and means of disease management with chronic heart failure in primary hospital. Methods：Carrying out health education, system guidance and regular follow-up; filling Self-care ability scale and the re-registration form; assessing self-care ability; Changing standards in drug utilization, 144 cases of disease management about CHF was fulfilled. Results：By the management of CHF patients, the self-care ability of various time periods and drug utilization were significantly increased, and continuously keep a high-level. Conclusions：Spreading prevention and treatment knowledge of CHF, providing patient health education, establishing CHF patient guidance and regular follow-up system are effective ways to CHF disease management.