中国典型病例大全

目的 旨在通过对基层医务人员管理高血压合并2型糖尿病和血脂异常（简称“三高”）的现状进行调查，了解基层医务人员防治“三高”的实际情况，以期为制定相关政策、指南和共识提供参考。方法 课题组于2023年10月采用两阶段分层随机抽样方法，通过专家访谈法制定调查问卷，问卷包含2部分内容，基本信息和19个“三高”共管的常见临床问题，使用问卷星向全国范围内基层医务人员发放问卷，进行在线调查。结果 数据显示，66.7%的基层医务人员在近3年管理“三高”患者超过50例，94.89%的基层医务人员医生认为有必要实行“三高”共管，81.24%的基层医务人员认为管理“三高”患者相对较难。基层医务人员在管理“三高”患者方面的问题主要集中于以下方面：联合用药（含中成药）治疗（60.56%）；药物不良反应监测和处理（62.15%）；康复治疗（67.48%）；相关并发症筛查和处理（61.55%）；依从性（65.48%）；自我管理方面（60.04%）；信息化管理（67.59%）。38.07%的基层医务人员认为如何提高患者依从性极其重要。结论 部分基层医务人员在“三高”共管方面存在较多问题，如联合用药（含中成药治疗）、药物不良反应监测和处理、康复治疗、相关并发症筛查和处理、依从性、自我管理和信息化管理等，且各问题均极为重要，需要加强对基层医务人员的培训和教育，提高其诊疗水平和健康管理能力。同时，制定科学的筛查和诊断方法、优化治疗方案、完善管理体系以及运用信息化技术，有助于提高“三高”共管的质量和效果。

Objective To investigate the current situation of the management of hypertension combined with type 2 diabetes and dyslipidemia( " three high ") among primary medical staff, and to understand the actual situation of the prevention and treatment of "three high". And providing reference for the formulation and implementation of relevant guidelines and consensus as well as policies. Methods In October 2023, the research group adopted the two-stage stratified random sampling method to investigate the nationwide primary medical staff. The questionnaire was developed by the expert interview method. The questionnaire has two parts, including basic information and 19 common clinical problems of "three high" co-management. The “sojump” platform was used for online survey. Results Data show that 66.7% of primary medical staff managed more than 50 cases of "three high" patients in the past three years. 94.89% of primary medical staff think it is necessary to implement "three high" co-management. 81.24% of primary medical staff think it is relatively difficult to manage "three high" patients. The problems in the management of "three high" patients were mainly concentrated in the following aspects: combined medication(including proprietary Chinese medicine)treatment(60.56%); adverse drug reaction monitoring and treatment(62.15%); rehabilitation treatment(67.48%); related complications screening and management(61.55%); compliance(65.48%); self-management(60.04%); information management(67.59%). 38.07% of primary medical staff thought that how to improve patients' compliance was extremely important, accounting for the largest proportion in the degree of importance of each problem. Conclusion There are many problems in the "three high" co-management of primary medical staff, such as combined drug use,adverse drug reaction monitoring and treatment, rehabilitation treatment, related complications screening and treatment, compliance, self-management and information management, etc. All these problems are extremely important, and it is necessary to strengthen the training and education of primary medical staff. Improve their diagnosis and treatment level and health management ability. At the same time, the development of scientific screening and diagnosis methods, the optimization of treatment plans, the improvement of management systems and the use of information technology will help to improve the quality and effect of the "three high" comanagement.