“微信+全程慢病管理”模式对慢性肾脏病3~4期疗效研究

目的探讨“微信+全程慢病管理”模式对慢性肾脏病(chronic kidney disease,CKD)3~4期的疗效。方法回顾性研究上海中医药大学附属龙华医院分院肾病科于2018年1月至2019年3月收治的CKD患者72例,根据患者健康管理模式的不同分为常规组36例,微信组36例。常规组给予常规管理模式干预,微信组给予微信+全程慢病管理模式干预。所有病例随访时间1年。观察比较两组患者干预前后血清白蛋白、血钾、血磷、血红蛋白、24 h尿蛋白定量、肾小球滤过率以及干预后有效率、生活质量、疾病认识、用药依从性、饮食依从性、满意度情况。结果(1)两组患者在干预后,血液及尿液指标均较治疗前明显改善(P<0.05),同时微信组血液及尿液指标明显优于常规组(P<0.05)。(2)微信组有效率(94.44%)明显高于常规组有效率(77.78%),差异具有统计学意义(P<0.05)。(3)干预后,两组患者在生活质量方面比较,微信组患者的心理障碍、生活状况及自理能力3项评分均显著高于常规组(P<0.05)。(4)微信组患者疾病认识率、用药依从率及饮食依从率均明显高于常规组,差异具有统计学意义(P<0.05)。(5)微信组患者对微信+全程慢病管理模式满意度(94.44%)显著高于常规组满意度(80.56%),差异具有统计学意义(P<0.05)。结论微信+全程慢病管理模式针对患者的不同疾病程度,进行早期干预,能够达到更好的宣教结果、更有效的预防肾脏疾病,延缓肾脏病的进展。

Treatment of chronic kidney disease stage 3~4 with"WeChat+chronic disease management"model

Objective To explore the efficacy of"WeChat+full-course chronic disease management"mode for chronic kidney disease(CKD)stage 3~4.Methods A retrospective study was performed for 72 hospitalized CKD patients from January 2018 to March 2019.They were divided into conventional and WeChat groups(n=36 each)according to the different health management models.The routine group received conventional management mode while WeChat group had"WeChat+full chronic disease management"mode.The follow-up period was 1 year.Two groups were compared with regards to estimated glomerular filtration rate(eGFR),albumin,potassium,phosphorus,hemoglobin,24h urinary protein quantification,post-intervention efficiency,quality-of-life,disease awareness,medication compliance,diet compliance and satisfaction.Results After interventions,blood and urine parameters of two groups significantly improved as compared with those pre-treatment(P<0.05).Blood and urine parameters were significantly better in WeChat group than those in conventional group.The effective rate of WeChat group was significantly higher than that of conventional group(94.44%vs 77.78%).And the difference was significant(P<0.05).WeChat group was significantly higher than conventional group in terms of psychological disorders,living conditions and self-care capability(P<0.05).The disease awareness rate,medication compliance rate and diet compliance rate were significantly higher in WeChat group than those in conventional group.And there were significant differences(P<0.05).The satisfaction degree of model was significantly higher than that of conventional group(94.44%vs 80.56%)and the difference was significant(P<0.05).Conclusions WeChat+full chronic disease management model is indicated for patients with varying degrees of disease.And early preventions may achieve better education outcomes,prevent kidney disease more effectively and delay the progression of kidney disease.