医院-社区-家庭三元联动模式在脑卒中血管内治疗患者二级预防中的应用

Application of hospital-community-family linkage management in the secondary prevention in patients with acute ischemic stroke of endovascular treatment strategy

目的探讨医院-社区-家庭三元联动模式在急性缺血性卒中(AIS)血管内治疗患者二级预防中的效果。方法选取2019年1月至2020年5月厦门大学附属中山医院收治的96例AIS血管内治疗患者作为研究对象,采用随机数字表法将其分为试验组和对照组,每组各48例。试验组患者采用医院-社区-家庭三元联动模式,对照组患者实施常规随访。比较两组患者干预前后的神经功能和卫生服务利用情况。结果试验组患者试验后的改良Rankin量表(mRS)评分低于对照组,差异有统计学意义(P<0.05)。试验组患者出院后6个月的急诊就诊例数少于对照组,差异有统计学意义(P<0.05)。试验组患者出院后6个月的门诊就诊例数多于对照组,差异有统计学意义(P<0.05)。两组患者出院后6个月的再次住院例数比较,差异无统计学意义(P>0.05)。结论医院-社区-家庭三元联动模式实现了急性缺血性卒中血管内治疗患者出院后的连续性照护,改善了患者的功能结局,保证了医疗资源的合理利用。

Objective To investigate the efficacy of hospital-community-family linkage management in the secondary prevention in patients with acute ischemic stroke(AIS)of endovascular treatment strategy.Methods A total of 96 AIS patients treated with endovascular therapy in Zhongshan Hospital Affiliated to Xiamen University from January 2019 to May 2020 were selected as the research objects.They were divided into experimental group and control group by random number table method,with 48 cases in each group.Patients in the experimental group were treated with hospital-community-family three-way linkage mode,while patients in the control group were followed up routinely.The neurological function and health service utilization were compared between the two groups before and after the intervention.Results The modified Rankin scale(mRS)score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).The number of emergency visits in the experimental group was less than that in the control group 6 months after discharge,and the difference was statistically significant(P<0.05).The number of outpatient visits in the experimental group was more than that in the control group 6 months after discharge,and the difference was statistically significant(P<0.05).There was no significant difference in the number of re-hospitalizations between the two groups 6 months after discharge(P>0.05).Conclusion The hospital-community-family linkage management provide continued care to patients after they discharged from hospital.It can improve the patients′ability of daily living and use of medical resources as well.