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目的探讨儿童哮喘医院内一体化诊疗服务模式。方法选择扬州大学附属连云港市妇幼保健院儿童哮喘科门诊2011年9月-2013年9月就诊的5岁以上支气管哮喘患儿162例,实施一体化诊疗服务模式,即以儿童哮喘专科门诊为主导,联合急诊科、中医科、耳鼻喉科、保健科、心理科、放射科、检验科等组建儿童哮喘一体化诊疗服务网络,实施儿童哮喘一体化诊疗及规范化管理,设为A组;2011年前未实施哮喘一体化管理的哮喘患儿148例,设为B组。比较两组患儿急性发作控制时间、3个月肺功能恢复人数(FEV1≥80%)、1年内哮喘急性发作≥3次人数、平均每月的治疗费用、依从率、流失率及满意率。结果 A组与B组相比,在急性发作控制时间、3个月肺功能恢复人数(FEV1≥80%)两项指标比较无统计学差异(P>0.05),A组患儿1年内哮喘急性发作次数明显少于B组(P<0.01),平均每月的治疗费用也少于B组(P<0.05),依从率及满意度明显高于B组(P<0.01),流失率明显低于B组(P<0.05)。结论儿童哮喘一体化诊疗服务方案在长期管理中,明显优于传统的管理方案,值得推广应用。
Objective To explore the integrated service model of pediatric asthma hospital. Methods Children asthma clinic of Lianyungang Maternal and Child Health Hospital of Yangzhou University was selected from September 2011 to September 2013. 162 children with bronchial asthma over the age of 5 were enrolled in this study. The integrated mode of service for diagnosis and treatment was adopted, which was dominated by pediatric asthma specialist clinics , Joint emergency department, Chinese medicine department, otolaryngology department, health department, psychology department, radiology department and laboratory department to set up an integrated diagnosis and treatment service network for childhood asthma and implement integrated diagnosis and treatment of childhood asthma and standardized management. A total of 148 asthmatic children without previous management of asthma were enrolled in group B. The duration of acute exacerbation control, 3-month pulmonary function recovery (FEV1≥80%), 1-year asthma exacerbation≥3 times, average monthly treatment cost, compliance rate, loss rate and satisfaction rate were compared between the two groups. Results There was no significant difference between the two groups (P> 0.05) in the number of pulmonary function recovery (FEV1≥80%) at 3 months after the onset of acute stroke in group A compared with that in group B. A group of children with acute asthma within 1 year The number of attacks was significantly less than that of group B (P <0.01), and the average monthly treatment cost was also less than that of group B (P <0.05). The compliance and satisfaction were significantly higher than those of group B (P <0.01). In group B (P <0.05). Conclusion In the long-term management of childhood asthma integrated service program, it is obviously superior to the traditional management plan and is worth popularizing and applying.