远程管理联合个案管理对消化性溃疡青年患者复发情况的影响研究

The effect of remote management combined with case management on the relapse of young patients with peptic ulcer

目的探讨远程管理联合个案管理对消化性溃疡青年患者复发情况的控制效果,为临床降低消化性溃疡青年患者复发率方案选择提供参考。方法选择我院2015年1月至2017年1月收治的消化性溃疡青年患者100例作为研究对象。所有患者按照入组先后顺序编号,采用数字随机表法将患者等分为A组和B组。所有患者符合出院指征后进入研究方案。两组患者均行远程管理对患者实施出院后护理,B组患者在远程管理的基础上再结合个案管理模式对患者行出院后护理。两组患者出院后第3,6,9,12个月回院随访,随访内容:临床症状、复发危险因素调查。统计患者在12个月观察期内第3,6,9,12个月因出现消化性溃疡临床症状且符合住院治疗指征者再住院率、患者对出院后护理的满意度、患者复诊率、患者复发率并比较。结果 B组患者入组后第3,6,9,12个月消化性溃疡复发危险因素发生率均明显低于A组患者(P<0.05);B组患者入组后第3,6,9,12个月消化性溃疡临床症状率、复发率、再住院治疗率明显低于A组患者(P<0.05),患者按照医嘱复诊率明显高于A组(P<0.05);B组患者入组后第3,6,9,12个月对护理的满意度均明显高于A组(P<0.05)。结论远程管理结合个案管理可有效降低患者出现消化性溃疡复发危险因素的发生率、消化性溃疡临床症状,提升患者的复诊情况和对护理的满意度,降低患者再住院治疗情况,具有较高的临床价值。

Objective To explore the effect of remote management combined with case management on the recurrence of peptic ulcer in young patients,and to provide a reference for reducing the relapse rate of young patients with peptic ulcer. Methods A total of 100 cases of patients with peptic ulcer treated in our hospital from January 2015 to January 2017 were selected as study subjects. All patients were numbered in accordance with the order of their enrollment,and they were divided into group A and group B equally using a digital random table method. All patients entered the study protocol after fulfilling hospital discharge indications. The two groups of patients underwent remote management to perform post-discharge care. Patients in group B were nursed by case management on the basis of remote management to perform post-discharge care. The two groups of patients were followed up at 3,6,9 and 12 months after discharge. The contents of follow-up included research of clinical symptoms and risk factors for recurrence. Re-hospitalization rates,patient satisfaction with care after discharge,patient return visits and recurrence rate of the patients who had clinical symptoms of peptic ulcer and were consistent with hospitalization indications at the 3 rd,6 th,9 th,and 12 th months during the 12-month observation period were collected and compared. Results The incidence of risk factors for peptic ulcer recurrence was significantly lower in the 3 rd,6 th,9 th,and 12 th month after admission in group B than in group A（ P〈0. 05）. At the 3 rd,6 th,9 th,and 12 th months,the clinical symptom rate,recurrence rate,and re-hospitalization rate of peptic ulcer in group B were significantly lower than those of group A（ P〈0. 05）. The rate of return visit according to doctor＇s orders was significantly higher than that of group A（ P〈0. 05）. At the 3 rd,6 th,9 th,and 12 th months after enrollment,the degree of satisfaction in group B was significantly higher than that of group A（ P〈0. 05）. Conclusion Remote management combined with case management can effectively reduce the occurrence of peptic ulcer recurrence risk factors,and peptic ulcer clinical symptoms. In addition,it can improve the patient＇s referral status and satisfaction with care,as well as reduce the patient＇s re-hospitalization treatment,and has higher clinical value.