社区随访新模式对老年幽门螺杆菌治疗疗效的影响

Effects of a new model of community follow-up on the therapeutic effect of Helicobacter pylori in the elderly

中文关键词: 老年  幽门螺杆菌  社区随访  新模式  疗效

英文关键词: elderly  Helicobacter pylori  community follow-up  new model  efficacy

中文摘要:

      目的 探索社区随访服务对老年幽门螺杆菌感染治疗效果的影响.方法 纳入2019 年1 月—2020 年12 月在上海市浦东新区周家渡社区卫生服务中心行13C尿素呼气试验阳性的老年患者(平均年龄66.0±3.76 岁)共320 例,采用随机数表的方式将患者随机分为新模式组(n =160)和常规组(n =160).2 组均在首次确诊后发放《幽门螺杆菌感染患者治疗指导》健康宣教处方,并接受正规药物治疗,新模式组在发放后,通过门诊、电话、微信等方式进行随访.常规组只进行门诊随访.对治疗后1 个月、6 个月、12 个月幽门螺杆菌感染患者的13 C-UBT阳性率、依从性及失访原因进行统计分析.结果 新模式组患者在服药后 6 个月及 12 个月的13 C-UBT阳性率均低于常规组(10.9%vs 17.8%,P =0.085;5.26%vs37.8%,P＜0.01),依从性高于常规组(94.4%vs 82.5%,P＜0.01),主观失访率低于常规组(12.5%vs 50.0%,P＜0.01).结论 社区随访服务新模式能提高老年Hp感染的治疗效果,并有效提高依从性,降低主观失访率.

英文摘要:

      Objective To explore the effects of community follow-up service on the therapeutic effect of Helicobacter pylori(Hp)in the elderly.Methods A total of 320 elderly patients(mean age 66.0±3.76 years old)who tested positive for 13 C urea breath test(13 C-UBT)at Zhoujiadu Community Health Service Center,Pudong New District,Shanghai from January 2019 to December 2020 were included.They were randomly divided into new model group(n =160)and conventional group(n =160)according to a random numbers table.The patients of both groups were given the health education prescriptions of"Guidelines for the Treatment of Helicobacter pylori Infection"after their initial diagnosis,and received formal medication treatment.The new model group was followed up through outpatient services,phone calls,We Chat,and other means.Only outpatient follow-up was performed in the conventional group.The positive rate of 13 C-UBT,compliance and reasons for loss of follow-up in patients with Hp infection at 1 month,6 months and 12 months after treatment were statistically analyzed.Results At 6 and 12 months after treatment,the positive rate of 13 C-UBT in the new model group was lower than that in the conventional group(10.9% vs 17.8% ,P =0.085;5.26% vs 37.8% ,P＜0.01),the compliance was higher than that of the conventional group(94.4% vs 82.5% ,P＜0.01),and the subjective loss rate was lower than that of the conventional group(12.5% vs50.0% ,P＜0.01).Conclusions The new model of community follow-up service can improve the therapeutic effect of Hp infection in the elderly,improve the compliance effectively,and reduce the subjective loss rate of follow-up.