摘要目的 通过医护协同工作模式对急性心肌梗死经皮冠状动脉介入治疗(PCI)术后患者1年预后的影响,探索心肌梗死慢性病管理的模式.方法 选择2011年10月1日至2013年9月30日收治的852例患者作为医护协同工作组,选择同期未开展医护协同工作模式的734例患者作为对照组.2组均进行1年随访.对比医护协同工作组和对照组治疗依从性、危险因素控制和心血管事件发生率的差别.结果 医护协同工作组的治疗依从性的改善情况优于对照组,主动改善生活方式、完全服药、定期复查的改善率分别是83.3％(710/852)、97.9％(834/852)、75.4％(642/852),而对照组为63.5％(466/734)、93.7％(688/734)、59.0％(433/734),x2=81.02、17.57、26.22,P值均＜0.01.医护协同工作组的危险因素控制率,包括高血压控制率、糖尿病控制率、高低密度脂蛋白胆固醇血症控制率分别是78.5％(252/321)、68.4％(214/313)、84.8％(491/579),对照组分别是55.8％(168/301)、58.1％(168/289)、79.9％(381/477),x2=36.47、6.79、4.41,P＜0.01或＜0.05.医护协同工作组在药物服用依从率和总心血管事件发生率方面也优于对照组.上述各项指标比较差异有统计学意义,P＜0.05.结论 医护协同工作模式是心肌梗死PCI术后提高患者治疗依从性、控制危险因素的有效途径和有效补充,可以改善患者的预后,是慢性病管理方式的有效探索.

abstractsObjective To explore the management model of chronic disease like myocardial infarction through the effect of collaborative work pattern of doctors and nurses on acute myocardial infarction patients with percutaneous coronary intervention(PCI) after 1 year follow up.Methods A total of 852 patients from October 1,2011 to September 30,2013 with collaborative work pattern of doctors and nurses were as collaborative work pattern group,and 734 patients without collaborative work pattern of doctors and nurses at the same time were as control group.The patients were followed up for 1 year.The differences of treatment compliance,risk factors control,and the incidence of cardiovasc~ar events were compared between collaborative work pattern group and control group.Results The improvement of treatment compliance in collaborative work pattern group was better than that in control group.The improvement rate of improve lifestyle initiatively,completely medication,check regularly were 83.3％(710/852),97.9％(834/852),75.4％(642/852) in collaborative work pattern group and 63.5％(466/734),93.7％(688/734),59.0％(433/734) in control group,x2=81.02,17.57,26.22,P＜0.01.The control rate of risk factors including hypertension,diabetic mellitus,high blood low density lipoprotein cholesterol were 78.5％ (252/321),68.4％ (214/313),84.8％ (491/579) in collaborative work pattern group and 55.8％ (168/301),58.1％ (168/289),79.9％ (381/477) in control group,x2=36.47,6.79,4.41,P＜0.01 or ＜0.05.The incidence of treatment compliance and total cardiovascular events in collaborative work pattern group were better than those in control group.There were significant differences in the above indices,P＜0.05.Conclusions Collaborative work pattern of doctors and nurses is an effective method and supplement for patients with myocardial infarction after PCI to improve treatment compliance and control risk factors.The prognosis of patients can be improved and this pattern is an effective exploration of chronic disease management.