健康管理在冠状动脉粥样硬化性心脏病患者三级预防中的应用

The clinical significance of health management on three grade prevention of patients with coronary atherosclerotic heart disease

目的探讨健康管理在冠状动脉粥样硬化性心脏病患者三级预防中的应用价值。方法入选体检疑诊为冠状动脉粥样硬化性心脏病(CAHD)的受检者共305例,对其行双源CT(DSCT)检查,评估检查结果。诊断为CAHD患者68人,将其随机分为两组,对照组34人,自行门诊治疗;观察组34人,在门诊治疗基础上,实施健康管理予以电话指导三级预防,每周一次。一年后比较两组入院人次、心电图及胸痛发作情况。结果对照组入院为16人次,心电图改善8人,胸痛发作50人次。观察组入院为5人次,心电图改善20人,胸痛发作20人次。与对照组比较,在统计学上均有显著差异(P<0.05)。结论通过健康管理予以电话指导三级预防可明显降低CAHD患者胸痛发作次数和患者入院率,减轻了患者负担,节约了社会资源,体现了人文价值,应在临床推广应用。

Objective To explore the clinical significance of health management on three grade prevention of patients with coronary atherosclerotic heart disease. Methods 305 cases with physical examination defined as suspected coronary atherosclerotic heart disease patients were selected to have further dual-source computed tomography（DSCT） test. 68 cases were diagnosed as coronary atherosclerotic heart disease. We randomized them as intervention group and control group. For control group, they went to the clinic for treatment by themselves. For the intervention group, except the clinic treatment, we gave them health management and instructions on three-grade preventions by telephone once a week. Hospital visits, electrocardiogram and chest pain attacks were compared between two groups. Results For the control group, there were 16 hospital visits, 50 person-times chest pain attacks and 8 persons with ECG improvement. For the intervention group, there were 5 hospital visits, 20 person-times chest pain attacks and 20 persons with improved ECG. Statistic significance was found between the two groups. Conclusion Health management on guiding on three-grade preventions by telephone instruction could significantly lower the chest pain attacks and hospital visits of coronary atherosclerotic heart disease patients. There is helpful to relieve the heavy burdens of patients and save the social resources.