摘要
目的探讨全科门诊简洁干预联合团队链式管理对血脂异常的干预效果。方法选取2017年4—6月于上海市杨浦区定海社区卫生服务中心全科门诊就诊的血脂异常患者203例为研究对象,随机分为对照组(n=102)和干预组(n=101),并根据心血管危险分层将两组患者分别分为低危、中危、高危、极高危亚组。对照组进行常规门诊和社区管理,干预组行全科门诊简洁干预联合团队链式管理。干预时间均为6个月。比较干预前后两组患者血脂水平和达标率。结果干预前,对照组和干预组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05)。干预后,干预组TC、TG、LDL-C水平低于对照组,差异有统计学意义(P<0.05);两组HDL-C比较,差异无统计学意义(P>0.05)。干预前,对照组和干预组LDL-C达标率比较,差异无统计学意义(P>0.05);干预后,干预组LDL-C达标率高于对照组,差异有统计学意义(P<0.05)。干预前,对照组和干预组低危、中危、高危、极高危4个亚组患者LDL-C达标率比较,差异无统计学意义(P>0.05)。干预后,干预组高危、极高危亚组患者LDL-C达标率高于对照组,差异有统计学意义(P<0.05);低危、中危亚组患者LDL-C达标率比较,差异无统计学意义(P>0.05)。结论全科门诊简洁干预联合团队链式管理可改善血脂异常患者的血脂管理效果,提高血脂异常患者的LDL-C达标率。
Objective To evaluate the effectiveness of concise intervention combined with group chain management on dyslipidemia in general clinics.Methods A total of 203 patients with abnormal blood lipid levelvisited Dinghai Community Health Service Center,Yangpu district of Shanghai from April to June 2017 were selected and randomly divided into control group(n=102)and intervention group(n=101).Subjects were further divided into very-high-risk,high-risk,intermediate-risk and low-risk groups according to different cardiovascular risk factors.The intervention group was treated with concise intervention and group chain administration for six months,whereas the control group received routine clinical treatment and community management.Lipid level and control rate were compared between two groups.Results There were no significant differences between levels of serum total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C)before intervention.After intervention,levels of TC,TG and LDL-C in intervention group were significantly lower than those in control group(P<0.05),and there was no significant difference in HDL-C between the two groups(P>0.05).Control rate of LDL-C in intervention group was significantly higher than that of control group(P<0.05)after intervention,while there was no significant difference before(P>0.05).Before intervention,there was no significant difference in control rate of LDL-C between low-risk,intermediate-risk,high-risk and very-high-risk subgroups in control group and intervention group(P>0.05).After intervention,control rate of LDL-C in high-risk and very-high-risk groups of intervention group were significantly higher than that in the same subgroups of control group(P<0.05).There was no significant difference in the control rate of LDL-C between low-risk and intermediate-risk subgroups(P>0.05).Conclusion Our research proposes the mode of combining general clinical concise intervention and group chain management,which can improve the management of blood lipid level and facilitate the control rate of LDL-C in patients with dyslipidemia.
作者
马佳
朱卫红
刘文斌
陆媛
黄春美
黄晨
夏瑾
张韶伟
MA Jia;ZHU Weihong;LIU Wenbin;LU Yuan;HUANG Chunmei;HUANG Chen;XIA Jin;ZHANG Shaowei(Yangpu District Dinghai Community Health Service Center,Shanghai 200090,China;Department of General Practice,Tongji University School of Medicine,Shanghai 200438,China)
出处
《中国全科医学》
CAS
北大核心
2018年第31期3882-3885,共4页
Chinese General Practice
基金
上海市杨浦区示范家庭医生培育项目(YP2017SQ001)
关键词
血脂异常
达标率
简洁干预
全科门诊
Dyslipidemia
Control rate
Concise intervention
General clinic
