医院与社区卫生服务中心联合干预对冠心病患者血运重建术后生存质量的影响

The impact of combined intervention of hospital and community health service center to the quality of life of patients with coronary heart disease after revascularization patients with coronary heart disease after revascularization

目的探讨医院与社区卫生服务中心联合干预模式对冠心病患者冠状动脉（以下简称冠脉）血运重建术后生存质量的影响。方法纳入冠脉血运重建术后1个月内的冠心病患者150例，按随机区组设计分成两组，联合干预组和对照组各75例。由我院专科医生为入选患者制定治疗方案，所有患者至少每月到我院专科门诊就诊1次；联合干预组患者由所在社区医生每周1次到其家中进行随访，开展卫生宣教，共随访12个月。入组及随访结束时发放诺丁汉健康量表（NHP）评价患者的生存质量，分析影响生存质量的相关因素。结果（1）经过12个月的干预，两组患者的生存质量均较入组时提高，但联合干预组患者的生存质量高于对照组，差异有统计学意义（P ＜0．05）。（2）医院与社区联合干预、性别、年龄、医疗付费方式、血运重建术方式和心肌梗死病史等因素对患者生存质量有影响（P ＜0．05）。结论医院与社区卫生服务中心联合干预模式可以提高冠脉血运重建术后冠心病患者的生存质量。

Objective To evaluate the model of combined intervention model of hospital and community health service center on the quality of life of patients of coronary atherosclerotic heart disease which accepted coronary artery revascularization treatment.Methods 150 patients who received revascu-larization within 1 month were enrolled.All patients were divided into two groups by randomized block design,combined intervention group and control group.Specialist of our hospital developed a treatment plan for every enrolled patient and adjusted it timely according to the change of patient’s condition.All the patients saw the specialist of our hospital at least once a month.In addition,the community doctors followed up the patients of combined intervention group in their home once a week and carried out health knowledge education,all the patients were followed up for 12 months.The Nottingham Health Profile （NHP）was issued on enrollment and the twelfth month to evaluate the quality of life of patients.Results （1）After 12 months of intervention,quality of life of the two groups of patients were improve,the quality of life of the patients’ in combined intervention group was higher than that of the control group,the difference was statistically significant（P 〈0.05）.（2）Hospital and community combined intervention im-proved the quality of life impacted by sex,age,medical payment,revascularization methods and whether there was a history of myocardial infarction.Conclusion Hospital and community health service center combined intervention can improve the quality of life of patients with coronary artery disease undergoing coronary revascularization.