关于社区心力衰竭患者基线自我管理状况的调查分析

Analyse on self-management for community heart failure patients

目的了解成都市社区的心力衰竭患者完成"自我管理"的基础状况,了解该模式目前所存在的缺陷,为寻找社区心力衰竭患者恰当的综合干预模式提供依据。方法采用分层、抽样办法对成都苏坡和新都城东两社区部分片区心力衰竭患者进行问卷调查、严格的体格检查,以及辅助的实验室检查,对患者的基线状况作出分析。结果社区心力衰竭患者疾病谱以高血压病、冠状动脉粥样硬化性心脏病、2型糖尿病为主,多名患者上述疾病共存。由于患者住院次数多,平均住院时间较长,住院花费高,因此,无论患者本人、家庭还是社会都希望患者能接受正规的自我管理指导而减少上述事件的发生。但事实表明,心衰患者无论对心衰知识的了解还是在日常生活自我管理的各方面都非常缺乏,都迫切需要社区医师乃至三级甲等医院医务工作者的正规指导。尤其在农村,社区管理的实施还需要进一步完善。结论社区心衰患者管理任重道远。对于社区患者的规范化管理需要尽快建立,以减少患者的高住院率、高医疗花费,提高患者的生存质量。

Objective From this study,we need to know whether the self-management was carried out well in community heart failure patients in our country,and to found the best intervention models for these patients.Methods Layered sampling method was used to investigate tow communities patients with heart failure.All the patients received questionnaire survey,physical examination and some laboratory examinations.We analyzed the patients＇ basic status finally.Results The main causes of community heart failure patients are hypertension,coronary artery disease and diabetes.The data show patients with heart failure are lack of standardized management,Especially in the Rural community.But the patients has a high hospitalization rates,high medical costs,they and their family members,community doctors,or even doctors of top-first hospital need the standardized management.Conculsion Community management of heart failure patients is very important and it still has a long way to go.In order to reduce the patients＇ high hospitalization rate,high medical cost and improve their life quality.Standardized management of heart failure patients in community needs to be established as soon as possible.