CAJ | 학술논문

采用整群抽样方法抽取10个社区60岁以上老人1 500名进行问卷调查和体格检查,结果检出心力衰竭(心衰)患者65人.回收的心衰患者问卷显示其中77.6％(38/49)在三级医院确诊,远高于社区医院(12.2％,6/49);心衰发作时,选择直接打车去三级医院的患者最多(37.7％,20/53),和社区医生联系的患者较少(17.0％,9/53);心衰发作后,有68.8％ (33/48)的患者可以在30 min内到达医院,55.3％(26/47)的患者可以在60 min内获得治疗;45.7％(21/46)的老年心衰患者每年因心衰住院1次,31.1％ (14/45)的患者每次因心衰住院时间小于10 d,出院后接受过健康教育的占46.0％(23/50),接受过用药监督的占40.0％ (16/40),健康教育者主要为社区医生,主要监督者为家庭成员.提示心衰的确诊和治疗仍依赖于二级医院,社区卫生机构在老年心衰患者院外健康教育和管理中发挥着重要作用,但目前心衰管理对社区卫生服务的利用度仍然较低.
채용정군추양방법추취10개사구60세이상노인1 500명진행문권조사화체격검사,결과검출심력쇠갈(심쇠)환자65인.회수적심쇠환자문권현시기중77.6％(38/49)재삼급의원학진,원고우사구의원(12.2％,6/49);심쇠발작시,선택직접타차거삼급의원적환자최다(37.7％,20/53),화사구의생련계적환자교소(17.0％,9/53);심쇠발작후,유68.8％ (33/48)적환자가이재30 min내도체의원,55.3％(26/47)적환자가이재60 min내획득치료;45.7％(21/46)적노년심쇠환자매년인심쇠주원1차,31.1％ (14/45)적환자매차인심쇠주원시간소우10 d,출원후접수과건강교육적점46.0％(23/50),접수과용약감독적점40.0％ (16/40),건강교육자주요위사구의생,주요감독자위가정성원.제시심쇠적학진화치료잉의뢰우이급의원,사구위생궤구재노년심쇠환자원외건강교육화관리중발휘착중요작용,단목전심쇠관리대사구위생복무적이용도잉연교저.
Total 1 500 subjects aged over 60 years were selected from 10 community health service centers with cluster sampling method.A questionnaire survey and physical examination were performed in all subjects.Sixty five patients with chronic heart failure were detected.The questionnaire showed that 77.6％ (38/49)patients were diagnosed in tertiary hospitals,and 12.2％ (6/49) were diagnosed in community hospitals.When heart failure occurred,most patients (37.7％,20/53) chose to take a taxi to the tertiary hospital directly,and less patients (17.0％,9/53)contacted community doctors.When a heart attack happened,68.8％ (33/48)of the patients could reach the hospital within 30 min,and 55.3％ (26/47) within 60 min.45.7％ (21/46) elderly patients were hospitalized for heart failure once a year;31.1％ (14/45) were in hospital for less than 10 d each time.46.0％ (23/50) heart failure patients had received health education and 40.0％ (16/40) had taken drugs under supervision;the majority health educators were community doctors and majority supervisors were family members.The results suggest that the confirmed diagnosis and treatment of heart failure patients still rely on tertiary hospitals,community health institutions play an important role in health education and management of heart failure patients outside hospitals.But the utilization of community health services is still not enough in community health service centers.