医院⁃社区⁃家庭联动管理方案在骨质疏松性椎体骨折病人二级预防中的应用研究

Its application on hospital⁃community⁃family linkage management program in the secondary prevention of patients with osteoporotic vertebral fractures

目的:探讨医院⁃社区⁃家庭联动管理方案在骨质疏松性椎体骨折病人二级预防中的应用效果。方法:选取与我院签订合作协议的6个社区卫生中心中的112例骨质疏松性椎体骨折住院病人,采用随机数字表法分为观察组和对照组各56例,对照组接受常规出院指导和电话随访,观察组在此基础上实施医院⁃社区⁃家庭联动管理,在病人干预1个月和1年后,比较两组病人的遵医行为、再次骨折入院率、危险因素控制率、骨密度值和生活质量变化。结果:干预1年后观察组病人遵医行为评分[(13.47±1.91)分]高于对照组[(10.13±1.86)分],再次骨折入院率(7.84%)低于对照组(28.57%),两组比较差异均有统计学意义(P<0.01);两组病人危险因素控制达标率、骨密度值、生活质量评分均优于对照组,两组比较差异有统计学意义(P<0.05)。结论:医院⁃社区⁃家庭联动管理可以改善骨质疏松性椎体骨折病人二级预防效果,提高病人的康复依从性,降低再次骨折发生率,提升病人的生活质量。

Objective:To explore the application effect of the hospital⁃community⁃family linkage management program in the secondary prevention of patients with osteoporotic vertebral fractures.Methods:A total of 112 inpatients with osteoporotic vertebral fractures from 6 community health centers that signed a cooperation agreement with our hospital were selected and divided into an observation group(56 cases)and a control group(56 cases)by a random number table.The control group received routine discharge guidance and telephone follow⁃up.On this basis,the observation group implemented hospital⁃community⁃family linkage management.After 1 month and 1 year of intervention,the two groups of patients'compliance behavior,re⁃fracture admission rate,risk factor control rate,changes in bone mineral density,and quality of life were compared.Results:After 1 year of intervention,the observation group patients'compliance behavior score(13.47±1.91)was higher than the control group(10.13±1.86);the rate of re⁃fracture admission(7.84%)was lower than that of the control group(28.57%).Difference between the two groups were statistically significant(P<0.01).The control rate of risk factors,bone mineral density value,and quality of life scores of the control group were better than those of the control group.The differences were statistically significant(P<0.05).Conclusions:The hospital⁃community⁃family linkage management could enhance the secondary prevention effect of patients with osteoporotic vertebral fractures,promote the patient's compliance with rehabilitation,reduce the incidence of re⁃fractures,and improve the patients'quality of life.