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昆士兰囊性纤维化患儿的临床结局:三级中心与外展服务的比较

Clinical outcomes of Queensland children with cystic fibrosis: a comparison between tertiary centre and outreach services.

作者信息

Thomas Clare L, O'Rourke Peter K, Wainwright Claire E

机构信息

Paediatric Department, Nambour General Hospital, Nambour, QLD, Australia.

出版信息

Med J Aust. 2008 Feb 4;188(3):135-9. doi: 10.5694/j.1326-5377.2008.tb01554.x.

Abstract

OBJECTIVE

To evaluate and compare the clinical outcomes of children with cystic fibrosis (CF) managed primarily at a tertiary cystic fibrosis centre (CFC) with those treated at regional centres by local health care professionals and the cystic fibrosis outreach service (CFOS).

DESIGN, SETTING AND PATIENTS: Retrospective study of 273 children with CF born between 19 October 1982 and 19 February 2002 and with clinical data available between 1 January 2000 and 31 December 2002. Patients were grouped into CFC (n = 131) or CFOS (n = 142), with CFOS then further categorised into three groups depending on the level of care they received.

MAIN OUTCOME MEASURES

Pulmonary function, Pseudomonas aeruginosa status, height and weight z scores, and hospital admission rates.

RESULTS

There were no significant differences in pulmonary function, P. aeruginosa status, or height and weight z scores between children managed by CFC or by CFOS. Children receiving more care at the CFC (level of care [LOC] 1 and 2) were more likely to have multiple hospital admissions than children receiving more care in regional areas (LOC 3 and 4) (P < 0.001).

CONCLUSION

The CFOS model provides effective delivery of specialised multidisciplinary care to children and adolescents living in rural and regional Queensland.

摘要

目的

评估并比较主要在三级囊性纤维化中心(CFC)接受治疗的囊性纤维化(CF)患儿与由当地医疗保健专业人员及囊性纤维化外展服务(CFOS)在地区中心治疗的患儿的临床结局。

设计、地点和患者:对1982年10月19日至2002年2月19日出生且在2000年1月1日至2002年12月31日期间有临床数据的273例CF患儿进行回顾性研究。患者被分为CFC组(n = 131)或CFOS组(n = 142),CFOS组再根据其接受的护理水平进一步分为三组。

主要结局指标

肺功能、铜绿假单胞菌感染情况、身高和体重Z评分以及住院率。

结果

CFC组和CFOS组患儿在肺功能、铜绿假单胞菌感染情况或身高和体重Z评分方面无显著差异。在CFC接受更多护理的患儿(护理水平[LOC]为1和2)比在地区接受更多护理的患儿(LOC为3和4)更易多次住院(P < 0.001)。

结论

CFOS模式为居住在昆士兰农村和地区的儿童及青少年提供了有效的多学科专科护理。

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