病程日记对肾病综合征患者管理效果的探讨

Study of the management effectiveness for patients with nephritic syndrome by disease course diary

目的探讨病程日记对肾病综合征患者实施慢性病自我管理的效果。方法将100例肾病综合征患者随机分成两组,实验组（50例）：入院时即教会和指导患者用课题组设计的病程日记本进行各项指标的记录并配合常规治疗及健康教育,嘱患者继续作病程日记,每2-4周复诊1次;对照组（50例）：入院时按常规治疗及健康教育,出院时予常规出院指导,嘱患者每2-4周复诊1次。结果与对照组相比,实验组患者对各种指标如尿量、蛋白尿、体重、血压、肾功能、激素及免疫抑制剂的用法用量等掌握较好,复诊率明显增加（P〈0.01）。结论采用病程日记对肾病综合征患者实施慢性病自我管理,可有效地将传统的被动式医学服务模式转变为以患者为中心的共同参与型的现代医学模式,且简便、价廉、效果好。

Objective To study the management effectiveness for patients with nephritic syndrome by disease course diary. Method 100 patients with nephritic syndrome were randomly divided into two groups.50 cases in group A was asked to record various indicators with the subject and health education when they are admission,and disease course diary and following up by doctor per 2-4 weeks was conducted after they discharged.50 cases in group B as control group was given conventional treatment and health education,and asked following up by doctor per 2-4 weeks after discharged.Result Compared with the Group B,Various indicators of Group A,such as proteinuria,qualitative urine protein,weight,blood pressure,using of hormones and Immunosuppressive agents,were better than that of group B.Conclusion Disease course diary used for patients with chronic nephritic syndrome self-management can change the traditional passive medical service into a common patient-centered participatory mode of physician-patient relationship in modern medicine effectively.It is simple,cheap and good effect.