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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
黄利平,张静,阮强,彭翼,李昭辉.下肢动脉硬化闭塞症居家管理模式的构建及初步实践[J].中华老年多器官疾病杂志,2020,19(1):34~37
下肢动脉硬化闭塞症居家管理模式的构建及初步实践
Establishment and preliminary practice of home management mode for lower extremity arteriosclerosis obliterans
投稿时间:2019-10-09  
DOI:10.11915/j.issn.1671-5403.2020.01.008
中文关键词:  下肢动脉硬化闭塞症;居家管理模式;效果
英文关键词:lower extremity arteriosclerosis obliterans; home management model; effect This work was supported by Major Project for Social Development of Yibin City
基金项目:宜宾市社会发展重大项目(2016YZY001)
作者单位E-mail
黄利平 宜宾市第一人民医院血管外科,宜宾 644000 1187510153@qq.comestablishment 
张静 宜宾市第一人民医院血管外科,宜宾 644000 1187510153@qq.comestablishment 
阮强 宜宾市第一人民医院血管外科,宜宾 644000 1187510153@qq.comestablishment 
彭翼 宜宾市第一人民医院血管外科,宜宾 644000 1187510153@qq.comestablishment 
李昭辉 宜宾市第一人民医院血管外科,宜宾 644000 1187510153@qq.comestablishment 
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中文摘要:
      目的 探讨下肢动脉硬化闭塞症(ASO)患者居家管理模式的构建及初步实践的效果。方法 选取2016年5月至2018年4月在宜宾市第一人民医院血管外科治疗并出院的81例下肢ASO患者为研究对象,按出院后管理模式的不同分为对照组40例和实验组41例。对照组患者在出院后1个月和12个月分别进行1次电话随访,实验组行居家管理模式,即居家管理小组通过电话随访+微信干预方式在患者出院后1、2、3、6、9、12个月对患者的遵医行为(服药、戒烟、饮食、康复运动、患肢保护、家属支持、定期复查)进行监督及指导。记录并比较2组患者各项遵医行为、复发和截肢比例,及ASO Fontaine分期改善情况。使用SPSS 19.0软件进行统计分析。组间比较采用卡方检验。结果 实验组出院时Fontaine Ⅰ~Ⅳ期依次有10、19、10、2例,出院12个月后依次有23、13、5、0 例。对照组出院时Fontaine Ⅰ~Ⅳ期依次有9、17、12、2例,出院12个月后依次有7、16、13、4例。出院时2组患者Fontaine分期构成比差异无统计学意义(P>0.05)。出院12个月后,2组患者Fontaine分期构成比差异有统计学意义(P<0.05)。与出院时比较,出院12个月后实验组患者ASO症状明显改善(P<0.05),而对照组患者ASO症状明显加重。与对照组比较,实验组患者出院12个月后,各项遵医行为好的比例显著增加,复发和截肢比例显著下降,差异有统计学意义(P<0.05)。结论 对下肢ASO实行居家模式管理能够提高患者依从性,改善下肢缺血情况,降低疾病复发率和截肢率。
英文摘要:
      Objective To investigate the establishment and preliminary practice of home management mode for patients with lower extremity arteriosclerosis obliterans (ASO). Methods A total of 81 patients with lower extremity ASO were enrolled, who were admitted to Department of Vascular Surgery of Yibin First People′s Hospital from May 2016 to April 2018. According to management modes employed after discharge, they were divided into control group (n=40) and study group (n=41). The patients in the control group were followed up by telephone at 1 and 12 months after discharge. For the study group, the home-based management mode was adopted,i.e. supervision and guidance were provided concerning the patients′ compliance behaviors (medication, smoking cessation, diet, rehabilitation exercise, limb protection, family support, and regular reexamination) via telephone + Wechat at 1,2, 3,6, 9 and 12 months after discharge. The two groups were compared in the respects of recorded rate of compliance, recurrence and amputation, and improvement of ASO Fontaine stage. SPSS statistics 19.0 was used for analysis, and Chi square test for the comparison between two groups. Results On discharge, 10 patients in the study group were of Fontaine stage Ⅰ, 19 of stage Ⅱ, 10 of stage Ⅲ, and 2 of stage Ⅳ; and the numbers were 23,3, 5 and 0 in the same order of stages at 12 months after discharge. In control group, 9 were of Fontaine stage Ⅰ, 17 of stage Ⅱ, 12 of stage Ⅲ, and 2 of stage Ⅳ, and the numbers were 7,6, 13, and 4 in the same order of stages at 12 months after discharge. There was no significant difference in the proportion of Fontaine stages between the two groups at the time of discharge (P>0.05). At 12 months after discharge, there was significant difference between the two groups in the proportion of Fontaine staging (P<0.05). Compared with those on discharge, the ASO symptoms in the study group were significantly improved at 12 months after discharge (P<0.05), while those in control group were significantly worse. Compared with control group, the proportion of patients with good compliance behaviors in the study group increased significantly, and the proportion with recurrence and amputation decreased significantly at 12 months after discharge (P<0.05). Conclusion The implementation of home management for the patients with lower extremity ASO can enhance patient′s compliance, alleviate lower limb ischemia, and reduce recurrence rate and amputation rate.
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