慢性心力衰竭患者医院-社区-家庭多元化管理模式的有效性研究

The Hospital-Community-Home Multilevel Intervention Care for Patients with Chronic Heart Hailure

目的:探讨管理慢性心力衰竭(CHF)患者的一种模式。方法:2006年1 月至2008年1月,159例CHF患者入选,干预组90例,对照组69例。比较两组患者的服药、再住院及死亡情况。结果:1年时两组服用ACEI(或ARB)制剂比例(71.1%vs 53.6%,P=0.03),β受体阻滞剂(63.3%vs 44.9%,P=0.03),两组的心力衰竭再住院情况(38.9%vs 56.5%,P=0.04);总死亡情况(13.3%vs 26%,P=0.06),心源性死亡情况(11.1%vs 24.6%,P=0.03)。结论:应用医院-社区-家庭多元化模式管理CHF患者减少了再住院率和心源性死亡率。

Objective： To evaluate the Hospital-Community-Home multilevel intervention care for patients with chronic heart failure（CHF）.Methods：From Jan.2006 to Jan.2008, 159 hospitalized patients with CHF were randomly assigned into intervention group （n = 90） and control group （n = 69） for a year. Clinical characteristics and follow-up results were compared between the two groups. Results： One-year follow-up indicated the rate of use ACE（or ARB）inhibitors between two group（71.1% vs 53.6%,P=0.03）, 13blockers（63.3% vs 44.9%,P=0.03）,and the rate of heart failure hospitalizations（38.9% vs 56.5%,P=0.04）, all-cause mortality（13.3% vs 26%,P=0.06）, heart mortality（l 1.1% vs 24.6%,P=0.03）. Conclusions：The Hospital-Community-Home multilevel intervention care for the management of patients with CHF reduce hospitalizations and also reduce heart mortality.