ra疾病活动性评分系统在类风湿关节炎护理管理中的应用.docVIP

RA疾病活动性评分系统在类风湿关节炎护理管理中的应用 　　[摘要] 目的 观察类风湿关节炎（RA）疾病活动性评分系统（DAS28）在RA患者护理管理中的应用效果。 方法 选取2015年3～9月我院风湿科收治的55例RA患者作为研究对象，通过培训使患者掌握DAS28的评估方法，并能自我定期复评，进行“达标治疗”。 结果 截止2015年9月，患者自我评估与医生/护士评估结果相比较，平均TJCs、SJCs和平均DAS28评分的同类相关系数（ICC）分别为0.96、0.96和0.98。随访发现，31%的患者用药方案发生了调整，治疗3个月后，DAS28活动度达标率由63.64%升高至89.09%。 结论 经DAS28评分系统培训，患者自我评估与医护人员评估结果一致性较好，借助DAS28评分可以更准确地了解患者病情，调整用药方案，进行“达标治疗”。 　　[关键词] DAS28评分系统；类风湿关节炎；护理；患者管理；达标治疗 　　[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2017）11-0122-03 　　Application of RA disease activity scoring system in rheumatoid arthritis nursing management 　　WU Zhuqun WANG Hongzhi ZHANG Bin MA Juanmei MIAO Guofang ZHANG Ye 　　Department of Rheumatology， Jiaxing City First Hospital in Zhejiang Province， Jiaxing 314000， China 　　[Abstract] Objective To observe the effect of rheumatoid arthritis（RA） disease activity scoring system（DAS28） in nursing care management of RA patients. Methods 55 patients with RA who were treated in the department of rheumatology in our hospital from March to September 2015 were selected as subjects. Patients were trained to master the DAS28 assessment methods， and underwent self periodic re-evaluation to carry out treat-to-target. Results The intraclass correlation coefficient（ICC） of mean TJCs， SJCs and DAS28 scores in the self-assessment of patients were 0.96， 0.96 and 0.98 respectively compared with the results of the physician/nurse assessment until September 2015. Follow-up found that medication program of 31% patients were adjusted， and after 3 months of treatment， DAS28 activity compliance rate increased from 63.64% to 89.09%. Conclusion Self-assessment of patients and assessment results of medical staff are consistent through training by the DAS28 scoring system. The DAS28 score can understand the patients condition more accurately and adjust the medication program to carry the treat-to-target. 　　[Key words] DAS28 scoring system； Rheumatoid arthritis； Nursing； Patient management； Treat-to-target 　　?风湿关节炎（RA）属于自身免疫性慢性疾病类型