家庭医师签约服务模式的双向转诊平台在泌尿系结石术后复发防治中的应用

Evaluation of the effect of a two-way referral platform based on the service of family doctors in the prevention and treatment of postoperative recurrence of urinary calculus

目的 探讨应用家庭医师签约服务及双向转诊平台构建的防治泌尿系结石术后复发系统的效果及价值。方法 选取2019年1月至2020年3月期间在我院行泌尿外科行手术治疗的200例泌尿系结石患者为对象,按照1∶1倾向性匹配法匹配65组病例,对照组(n=65例)和干预组(n=65例),对照组术后予以常规的健康教育,结石防治教育工作及电话随访;干预组术后由签约家庭医师应用网络微信平台访视和/或上门随访进行术后结石防治及健康教育工作,观察两组患者并对比其临床症状的改善情况,术后感染、复发、再入院情况以及患者的满意度。结果 干预组的术后腹痛缓解时间、血尿消失时间、感染控制时间、排石时间均明显短于对照组(P<0.05);干预组随访期间感染、复发、再入院率均明显低于对照组(P<0.05);干预组满意度明显高于对照组(P<0.05)。结论 家庭医师签约服务引入双向转诊平台可系统性防治泌尿系结石复发,可加快患者术后恢复。

Objective To explore the effect and value of the system based on the contracted service of family doctors and the two-way referral platform for the prevention and treatment of recurrence of urinary calculus.Methods The data of 200 patients with urinary calculus who underwent surgical treatment in our hospital from January 2019 to March 2020 were analyzed retrospectively.The patients were matched into control group(n=65)and intervention group(n=65)according to 1∶1.Coventional postoperative health education,calculus prevention education and telephone follow-up were given in the control group.And in the intervention group,the follow up were performed by the family doctor via home visit and/or online WeChat platform.The observation indexes included the improvement of clinical symptoms,postoperative infection,recurrence,readmission,and patient satisfaction.Results The postoperative abdominal pain relief time,hematuria disappearance time,infection control time,and stone removal time of the intervention group were shorter than those of the control group(P<0.05).And the infection,recurrence and readmission rates during the follow-up period of the intervention group were lower than those of the control group(P<0.05).The rate of satisfaction in the intervention group was higher than those of the control group(P<0.05).Conclusions The two-way referral platform based on the contracted service of family doctors can speed up the recovery and reduce the recurrence of patients after surgery.