医院-社区-家庭一体化防治管理用于静脉血栓栓塞症高危患者中的价值

The value of hospital-community-family integrated prevention and management in patients with high risk of venous thromboembolism

目的:探讨医院-社区-家庭一体化防治管理用于静脉血栓栓塞症(VTE)高危患者中的价值。方法:利用前瞻性和回顾性研究的方法。前瞻性队列:选取2019年6月至2020年2月在我院骨关节科和肿瘤化疗科符合条件的患者分别为20例、30例;回顾性队列:选取2015年3月至2016年3月在我院骨关节科和肿瘤化疗科住院患者分别为20例、30例;共计100例VTE高危患者作为研究对象。其中,接受常规诊治与防治管理的50例患者为对照组,另外50例患者加以医院-社区-家庭一体化防治管理,为观察组,对两组干预情况进行比较分析。结果:观察组VTE评估正确率、VTE高危患者VTE相关知识知晓率、社区医护人员VTE防治护理知识掌握率及VTE高危患者家庭防栓措施落实率均较对照组显著更高(P<0.05);干预前两组患者自我管理水平评分比较无明显差异(P>0.05),干预后观察组患者自我管理评分较对照组明显更高(P<0.05);干预前两组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较无明显差异(P>0.05),干预后观察组各评分均显著低于对照组(P<0.05)。结论:医院-社区-家庭一体化防治管理应用于VTE高危患者中有助于准确评估VTE,提高高危患者对VTE的认知及家庭防栓措施的落实度,使社区医护人员更有效地掌握VTE防治知识,也能促进患者提高自我管理水平,减轻心理负担,值得推广。

Objective:To explore the value of hospital community family integrated prevention and management in highrisk patients with venous thromboembolism(VTE).Methods:Prospective and retrospective research methods were used.Prospective cohort:20 patients and 30 eligible patients in the Department of Orthopaedics and Oncology and Chemotherapy in our hospital from June 2019 to February 2020 were selected.Retrospective cohort:March 2015 to March 2016,there were 20 and 30 inpatients in our department of Orthopedics and Oncology and Chemotherapy;A total of 100 patients at high risk of VTE were used as the research object.Among them,50 patients who received routine diagnosis and treatment management were divided into the control group,and the other 50 patients were treated with integrated hospital-communityfamily management.Comparative analysis of the situation.Results:The correct rate of VTE assessment in the observation group,the awareness rate of VTE-related knowledge in high-risk VTE patients,the grasp rate of VTE prevention and nursing knowledge among community medical staff,and the implementation rate of home anti-embolic measures in highrisk patients were significantly higher than those in the control group(P<0.05);There was no significant difference in the scores of the self-management level between the two groups of patients before the intervention(P>0.05),and the self-management scores of the observation group were significantly higher than that of the control group after the intervention(P<0.05).There were no significant difference in the anxiety self-assessment scale(SAS)and depression selfassessment scale(SDS)between the two groups before the intervention(P>0.05),and the scores of the observation group after the intervention were significantly lower than those of the control group(P<0.05).Conclusion:The application of hospital community family integrated prevention and control management in VTE high-risk patients is helpful to evaluate VTE accurately,improve the cognition of high-risk patients to VTE and the implementation of family antithrombotic measures,make community medical staff master VTE prevention and control knowledge more effectively,and promote the improvement of patients’self-management level and reduce their psychological burden,which is worth popularizing.