三级医院联合社区医院治疗腰椎间盘突出症模式探索

目的探索社区医院对老年骨关节疾病尤其是腰椎间盘突出症的经济、有效的诊疗模式。方法将上海市徐家汇社区卫生服务中心接诊的老年腰椎间盘突出症患者设为观察组(n=62)，将上海市华泾社区卫生服务中心和上海市第六人民医院接诊的腰椎间盘突出症患者设为对照组A(n=48)和对照组B(n=55)。观察组患者由与之联合的三级医院康复科副主任以上医师按照轻、中、重分级治疗，对照组A和对照组B按照常规治疗。3 个月后，对三组患者进行疗效评定和支付费统计。结果观察组与对照组B疗效无显著性差异(P>0.05)，均优于对照组A(P<0.05)。观察组支付费最低(观察组<对照组A<对照组B)。结论社区医院在三级医院指导下分级治疗老年腰椎间盘突出症既经济又有效。

Management Strategy of Lumbar Disc Herniation in Community Health Center United Tertiary Hospital

Objective To explore an economic and effective management strategy for lumbar disc herniation (LDH) in community health center. Methods 62 LDH patients treated in Xujiahui community health center (observation group), 48 LDH patients treated in Huajing community health center (control group A) and 55 LDH patients treated in Shanghai 6th People's Hospital (control group B) were included.The observation group was managed by associate professor from Shanghai 6th People's Hospital and accepted different treatment strategy in mild, medium and heavy grades. The control groups A and B were managed routinely. 3 month later, costs of illness were computed and curative effects were accessed in 3 groups. Results There was no difference in curative effects between observation group and control group B (P>0.05), but better than control group A (P<0.05). The observation group cost the least among the groups (P<0.05). Conclusion Graded treatment strategy united with tertiary hospital is an economic and effective mode for LDH management in community health center.