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目的探讨以社区为基本单元以全科医学理论作为指导的老年慢性心力衰竭(CHF)治疗的模式及方法。方法将老年慢性心力衰竭患者109例随机分成社区治疗组(A组)59例和对照组(B组)50例;两组心力衰竭患者均按常规治疗。治疗组由社区医生和护士对每个患者进行督导和干预:包括药物调整、健康教育、改良生活方式等。观察所有患者不良生活方式改变情况、遵医服药情况、再住院率、心功能改善程度、猝死率及医疗费用。结果治疗组与对照组相比在生活方式改良、遵医行为、再住院率、心功能改善、病死率及医疗费用等方面差异有统计学意义(P(0.01)。结论通过社区干预能提高患者对治疗及康复方案的依从性,可以有效的改善患者的生活质量,减少住院总天数,降低再住院率及医疗费用。
Objective To explore the mode and method of treatment of senile chronic heart failure (CHF) guided by general medical theory taking community as the basic unit. Methods 109 elderly patients with chronic heart failure were randomly divided into community treatment group (group A) 59 cases and control group (group B) 50 cases; two groups of patients with heart failure were treated routinely. In the treatment group, each patient was supervised and interfered by community doctors and nurses: drug adjustment, health education, lifestyle improvement and so on. All patients were observed adverse changes in lifestyle, compliance medication, rehospitalization, improvement of cardiac function, sudden death and medical costs. Results Compared with the control group, the treatment group had statistically significant differences in life style improvement, compliance, rehospitalization rate, cardiac function improvement, case fatality rate and medical expenses (P <0.01) .Conclusion Community intervention can improve patients Compliance with treatment and rehabilitation programs can effectively improve the quality of life of patients, reduce the total number of hospital days, reduce the rate of rehospitalization and medical expenses.