子宫内膜异位症立体化长期管理模式的构建

Construction of multidimensional and long-term management mode on endometriosis

目的通过创建子宫内膜异位症一体化诊治管理中心,为患者提供专病门诊-专病病房-随访中心于一体的闭环式专病诊疗管理区域,实现对子宫内膜异位症患者的全病程精细化管理。方法通过多角度发挥子宫内膜异位症中心的平台辐射作用,包括规范疾病诊治管理、开展科普宣教、培养专病人才、开展疾病科学研究、帮扶基层及顺畅分级诊疗等,实现对子宫内膜异位症专病的全方位综合管理,从而构建兼顾患者诊治-专病管理-区域诊疗的子宫内膜异位症三维管理新模式。结果2021年3月—2023年3月,到子宫内膜异位症中心就诊的子宫内膜异位症相关患者共1559例。中心建成前后相比较,子宫内膜异位症患者长期管理率由43.1%上升至83.4%,健康知识知晓率由55.6%上升至100.0%,市外患者就诊率由12.2%增加至31.4%。中心建成后,专病病房子宫内膜异位症相关手术增加50.4%,子宫内膜异位症相关疑难危重病例增加57.6%,患者综合满意度98%以上。中心指导培养基层子宫内膜异位症技术骨干近20名,帮助4个基层单位开设子宫内膜异位症门诊。结论新模式的实践,提高了患者生活质量,促进了专科发展,优化了医疗资源分布,促进了区域子宫内膜异位症整体诊治水平的提升,成效显著,也为临床上专病特色慢病管理模式的构建提供了参考依据。

Objective To establish multidimensional diagnostic,treatment,and management center of endometriosis,provide a closed-loop special disease diagnosis,treatment and management area integrating special disease out-patient,special disease ward,and follow-up center,and realize refined management of the whole course of patients with endometriosis.Methods The radiating role of the platform of endometriosis center should be realized from various angles,including standardizing the diagnosis and treatment of diseases,carrying out public science education,training specialized disease talents and teams,carrying out disease scientific research,helping the grassroots,and smoothly grading diagnosis and treatment,then comprehensive management of endometriosis and specific diseases was realized,the new mode including patient diagnosis and treatment,special disease management,and regional diagnosis and treatment of endometriosis,was constructed.Results From March 2021 to March 2023,1559 patients with endometriosis went to endometriosis center.Compared with before construction of endometriosis center,the long-term management rate increased from 43.1% to 83.4% after construction of endometriosis center,the awareness rate of health knowledge increased from 55.6% to 100.0%,the outpatient rate of patients from other cities increased from 12.2% to 31.4%.After construction of endometriosis center,the surgery related to endometriosis in special disease wards increased by 50.4%,the intractable and critical cases related to endometriosis increased by 57.6%,the comprehensive satisfaction rate was more than 98%.Endometriosis center cultivate nearly 20 technical backbones of endometriosis,and helped four grassroots units to construct endometriosis outpatient.Conclusion The new mode improves the quality of life,promotes specialty development,optimizes the distribution of medical resources,promotes the improvement of the whole diagnosis and treatment level of endometriosis,the effect is significant,which provides a reference basis for construction of specialized disease characteristics and chronic disease management mode.