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中文摘要: 目的 探讨分级诊疗模式下家庭医生转诊对于慢性肾脏病的干预效果，旨在进一步提升对社区慢性肾脏病的干预策略。方法 选取2016年9月—2017年8月上海市闵行区华漕社区卫生服务中心收治的60岁及以上的慢性肾脏病及疑似患者为转诊组(n=55)，进行尿蛋白肌酐比（ACR）及血清肌酐（SCR）检测，通过CKD-EPI公式计算出估算的肾小球率过滤（eGFR），对其进行3个月、1年上述指标变化的比较，同时对存在上述指标异常未进行转诊的患者为对照组(n=52），进行SCR、eGFR初始及1年ACR比较。结果 转诊组患者3个月、1年ACR和eGFR较原始值均有相应改善，对照组较转诊组呈加重趋势。结论 通过转诊前后及与未转诊组ACR、eGFR指标比较，分级诊疗模式下家庭医生转诊对于CKD的早发现、控制和延缓有积极干预效果。
Abstract:OBJECTIVE To explore the intervention effect of family doctor referral on chronic kidney disease under the grading diagnosis and treatment mode, aiming to further improve the intervention strategy for chronic kidney disease in the community. METHODS From September 2016 to August 2017,Chronic kidney disease and suspected patients aged 60 years and above who were admitted to Huacao community health service center in Minhang District of Shanghai were transferred to the referral group(n=55).The urine protein creatinine ratio (ACR) and serum creatinine (SCR) were measured.The estimated glomerular rate filtration(EGFR) was calculated by CKD-EPI formula,and the changes of the above indexes were compared for three months and one year，while the patients without referral were compared with the control group(n=52).RESULTS The ACR and EGFR of the patients in the referral group were improved in 3 months and 1 year compared with the original values, while the control group was more severe than the referral group.CONCLUSION Compared with the ACR and eGFR indicators before and after referral, the referral of family doctors in the graded diagnosis and treatment mode has positive effects on the early detection、control and delay of CKD.
文章编号：3202003006 中图分类号：R197 文献标志码：
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