疾病管理计划对缺血性脑卒中患者卒中复发的影响

Effect of disease management programs on stroke recurrence in patients with ischemic stroke

目的 探讨疾病管理计划（DMPs）预防缺血性脑卒中（IS）复发的效果.方法 采用前瞻性随访研究,选取2012年1月—2013年12月笔者所在医院收治的缺血性脑卒中患者182例,随机分为试验组（n=88）和对照组（n=94）.对照组接受传统的出院健康教育,试验组接受6个月的疾病管理计划,比较两组患者缺血性脑卒中的复发情况.结果 两组患者的随访时间为6~45个月,中位时间33个月.试验组有5例复发IS,复发时间为10~35个月,中位时间20个月;3年无IS复发生存率为92.8%;对照组有14例复发IS,复发时间为4~28个月,中位时间13个月;3年无IS复发生存率为84.3%;试验组无IS复发生存率高于对照组,差异有统计学意义（χ2=4.371,P〈0.05）.结论 疾病管理计划能够降低缺血性脑卒中的复发,值得在临床中进一步推广应用.

Objective To explore the effect of disease management programs （DMPs） on prevention of recurrence of ischemic stroke （IS）.Methods This study was a prospective follow-up study which included 182 subjects with IS between January 2012 and December 2013. These subjects were divided into study group （n=88） and control group （n=94） randomly. The patients of study group received six months of DMPs and the pa-tients of control group received conventional health education at discharge.Results The follow-up was carried out 33 months （6-45 months） averagely in two groups. 5 cases recurred IS in the study group, with the time to recurrence of 20 （10-35） months, and 3-year recurrence-free survival rate was 92.8%; 14 cases recurred IS in the control group, with the time to recurrence of 13 （4-28） months, and 3-year recurrence-free survival rate was 84.3%. Recurrence-free survival rate in study group was significantly increased than the control group（χ2=4.371, P〈0.05）.Conclusions Disease management programs can significantly reduce the recurrence of ischemic stroke, which is worthy of applying in clinical work further.