曾斐 叶屏 吕云凤 陈亮

【摘要】 目的：探究醫院伤口中心联合签约家庭医生服务模式对居家压疮患者的处理效果。方法：选取笔者所在医院2017年9月-2019年6月出院的80例压疮患者为研究对象，均为单部位压疮，采用随机数字表法将其分为对照组和观察组，每组40例。对照组由伤口中心和患者家属对伤口进行延续护理，观察组由签约家庭医生、伤口中心与患者家属结合的个案管理团队共同完成伤口处理。统计两组3个月压疮治愈情况及6个月压疮再发生情况;比较两组干预前后Barthel指数评分及Norton评分;比较两组对护理态度、护理技术及健康教育满意度。结果：观察组3个月压疮治愈率高于对照组，6个月压疮再发生率低于对照组，护理满意度高于对照组，差异均有统计学意义（P<0.05）;干预后两组Barthel指数评分及Norton评分均高于干预前，且观察组评分均高于对照组，差异均有统计学意义（P<0.05）。结论：将医院伤口中心联合签约家庭医生模式应用于压疮患者的居家护理中，可降低压疮发生危险性，改善生活质量，提高护理满意度。

【关键词】 医院伤口中心 家庭医生服务模式 压疮 居家护理

doi：10.14033/j.cnki.cfmr.2020.13.068 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Study on the Effect of Hospital Wound Center Joint Contract Family Doctor Service Model on Treatment of Home-based Pressure Sore Patients/ZENG Fei， YE Ping， LYU Yunfeng， CHEN Liang. //Chinese and Foreign Medical Research， 2020， 18（13）： -166

[Abstract] Objective： To explore the treatment effect of hospital wound center and contracted family doctor service mode on patients with pressure sore at home. Method： A total of 80 patients with bedsore discharged in our hospital from September 2017 to September 2019 were selected as the study objects， all of them were single site bedsore. They were divided into the control group and the observation group by random number table method， 40 cases in each group. In the control group， the wound center and the patients family members continued to care for the wound. In the observation group， the contracted family doctor， the case management team of the wound center and the patients family members jointly completed the wound treatment. The treatment of pressure sore in 3 months and the recurrence of pressure sore in 6 months of two groups were analyzed， the Barthel index score and Norton score before and after the intervention of two groups were compared， the satisfaction with nursing attitude， nursing technology and health education of two groups were compared. Result： The cure rate of pressure sore in 3 months in the observation group was higher than that in control group， the recurrence rate of pressure sore in 6 months was lower than that in the control group， and the nursing satisfaction was higher than that in the control group， the differences were statistically significant （P<0.05）. After intervention， the Barthel score and Norton score in the two groups were higher than those before intervention， and the scores in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The combination of hospital wound center and contracted family doctor model can reduce the risk of pressure sore， improve the quality of life and improve the satisfaction of nursing.

[Key words] Hospital wound center Family doctor service mode Pressure sore Home care

First-authors address： Shaoguan First Peoples Hospital， Shaoguan 512000， China

压疮又称压力性溃疡、褥疮，是由于局部组织长期受到压迫，发生持续性缺血、缺氧、营养不良而致组织溃烂坏死，皮肤压疮是康复治疗及护理干预中最常见的并发症之一，据有关报道指出，压疮在普通医疗中心的发病率高达2.7%～29.5%，严重危害了患者的生命质量[1]。护理干预及体育运动是降低压疮发生危险性的主要因素，切实有效的护理干预不仅能起到预防压疮发生的作用，还能对已产生压疮患者的后期恢复起到较好的促进作用。医院伤口中心服务模式是压疮患者最常见的居家护理模式，但护理效果不佳[2]。……