| 摘要: |
| ［摘要］ 目的 分析医院-社区联动管理模式对烟雾病患者术后血压控制、神经功能及生存质量的影响。方法 招募2022年1月至2023年12月在首都医科大学附属北京天坛医院进行脑血流重建术的247例烟雾病患者。将2022年1月至9月入组的患者作为对照组（136例），2022年10月至2023年12月入组的患者作为观察组（111例）。对照组采用神经外科术后标准化护理方案，无医院-社区联动管理介入。观察组采用“多学科协作+社区联动”一体化管理方案。两组均干预12周。比较两组干预前后的收缩压、舒张压、卡氏功能状态（KPS）评分、改良Rankin量表（mRS）评分、中国失语症语言评估量表中的语言功能评分和世界卫生组织生存质量测定量表（WHOQOL-BREF）中文版评分。结果 最终183例患者纳入分析，剔除率25.91%，对照组94例，观察组89例。干预前，两组收缩压、舒张压比较差异无统计学意义（P>0.05）。干预后，两组收缩压、舒张压较干预前显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。在干预4周后（T3）、干预12周后（T4）观察组KPS评分显著高于对照组（P<0.05），中国失语症语言评估量表中的语言功能评分、mRS评分显著低于对照组（P<0.05）。干预后两组在WHOQOL-BREF中文版中的生理、心理、环境、社会关系方面的评分显著高于干预前（P<0.05），且观察组显著高于对照组（P<0.05）。结论 医院-社区联动管理模式能显著改善烟雾病术后患者的血压控制、神经功能及生存质量。 |
| 关键词: 烟雾病 术后护理 社区卫生服务 脑血流重建术 |
| DOI：10.3969/j.issn.1674-3806.2026.01.16 |
| 分类号:R 473.6 |
| 基金项目:国家重点研发计划“常见多发病防治研究”重点专项（编号：2021YFC2500502） |
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| Effects of the hospital-community collaborative management model on postoperative blood pressure control, neurological function and quality of life in moyamoya disease patients |
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XUE Rui, ZHAO Donghong, LI Na, GUI Jinmin, CHEN Hongyan, DONG Xinxin, LIU Xingju, HUANG Liangran
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Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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| Abstract: |
| ［Abstract］ Objective To analyze the effects of the hospital-community collaborative management model on postoperative blood pressure control, neurological function and quality of life in moyamoya disease patients. Methods A total of 247 patients with moyamoya disease who underwent cerebral revascularization in Beijing Tiantan Hospital, Capital Medical University from January 2022 to December 2023 were recruited. The patients enrolled from January 2022 to September 2022 were taken as control group(136 patients), and those enrolled from October 2022 to December 2023 were taken as observation group(111 patients). The control group received the standardized nursing care plan after neurosurgical operation, without intervention of the hospital-community collaborative management. The observation group received a unified management plan of “multi-disciplinary collaboration+community collaborative management”. Both groups were intervened for 12 weeks. The systolic blood pressure, diastolic blood pressure, Karnofsky Performance Status(KPS) scores, modified Rankin Scale(mRS) scores, language function scores in Chinese Aphasia Battery(CAB) scale and World Health Organization Quality of Life-BREF Scale(WHOQOL-BREF)(Chinese version) scores were compared between the two groups before and after the intervention. Results Ultimately, 183 patients were included in the analysis, with 94 cases in the control group and 89 cases in the observation group, and the exclusion rate was 25.91%. Before the intervention, there were no statistically significant differences in systolic blood pressure and diastolic blood pressure between the two groups(P>0.05). After the intervention, the systolic blood pressure and diastolic blood pressure in both groups were significantly lower than those before the intervention(P<0.05), and the systolic blood pressure and diastolic blood pressure in the observation group were significantly lower than those in the control group after the intervention(P<0.05). The KPS scores in the observation group were significantly higher than those in the control group at 4 weeks after the intervention(T3) and 12 weeks after the intervention(T4)(P<0.05). At the time points of T3 and T4, the language function scores in CAB scale and the mRS scores in the observation group were significantly lower than those in the control group(P<0.05). After the intervention, the scores in physiological, psychological, environmental and social relationship dimensions of the WHOQOL-BREF(Chinese version) in both groups were significantly higher than those before the intervention(P<0.05), and these scores in the observation group were significantly higher than those in the control group after the intervention(P<0.05). Conclusion The hospital-community collaborative management model can significantly improve the blood pressure control, neurological function and quality of life in moyamoya disease patients after neurosurgical operation. |
| Key words: Moyamoya disease Postoperative care Community health services Cerebral revascularization |
