支气管哮喘社区管理模式的探索

The exploration in community management model of asthma

目的探讨支气管哮喘（哮喘）社区管理的有效方法。方法根据《全球支气管哮喘防治倡议》和《支气管哮喘防治指南》的要求，结合社区门诊部的实际情况，建立支气管哮喘社区管理模式，并对实施社区管理前和1年后哮喘患者的病情、用药、医疗费用等情况进行比较和分析。结果纳入社区管理后，哮喘患者的病情明显改善，急诊就医和住院次数较前减少，抗生素和地塞米松使用明显减少，吸入激素、制定哮喘计划、使用峰流速仪以及定期进行呼气流量峰值和哮喘控制测试监测人数均较前增加。结论将支气管哮喘纳入社区管理，建立以患者为中心，医生和患者共同参与的社区管理模式，是提高哮喘控制水平的有效途径。

Objective To explore an effective method in community management of bronchial asthma（ asthma）. Methods According to the requirements of ＂Global Initiative for Asthma ＂（GINA） and＂ Guidelines for Prevention and Treatment of Asthma＂, combined with the actual situation of community outpatient department, community management model of asthma was established. Before the implementa- tion of community management and one year later, the condition, medication, medical cost, and so on, of the asthma patients were compared and statistically analyzed. Results After the implementation of community management the condition of asthma patients improved significantly, the frequency of emergency medical treatment and hospitalization reduced, the use of antibiotics and dexamethasone decreased significandy, and the number of patients who inhaled corticosteroids, formulated asthma plan, used peak flow meter, as well as regularly monitored peak expiratory flow （PEF） and asthma control test （ACT） increased than before. Conclusions The implementation of community management of asthma and establishment of the community management mode taking patients as the center and participated by physicians and patients, is an effective way to improve asthma control.