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川崎病合并冠状动脉病变患者的医疗护理过渡

Health-care transition after Kawasaki disease in patients with coronary artery lesion.

作者信息

Kamiyama Hiroshi, Ayusawa Mamoru, Ogawa Shunichi, Saji Tsutomu, Hamaoka Kenji

机构信息

Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Japan.

Division of Medical Education Planning and Development, Nihon University School of Medicine, Itabashi, Japan.

出版信息

Pediatr Int. 2018 Mar;60(3):232-239. doi: 10.1111/ped.13500.

Abstract

BACKGROUND

Discussion of health-care transition (HCT) for adults with a childhood history of coronary artery lesions (CAL) after Kawasaki disease (KD) is important. A nationwide questionnaire survey was performed with support by the Japanese Society of Kawasaki Disease. The purpose of this study was to clarify the reality of HCT and loss to follow-up in patients with CAL after KD.

METHODS

The survey was emailed to 48 members of the Japanese Society of Kawasaki Disease from May to July 2014.

RESULTS

Forty surveys were collected, giving a response rate of 83.3%. Sixty-five percent of the respondents belonged to a university hospital. Approximately 90% of the respondents dealt with patients who needed HCT, and 55% had patients who completed HCT. Approximately 70% of the respondents considered that pediatricians should continue sharing HCT information with cardiologists. More than 95% of the respondents had a favorable or average impression of HCT care provided by cardiologists. The percentage of respondents who had loss to follow up for HCT was >40%.

CONCLUSION

Adult cardiologists began managing patients with CAL after KD in more than half of the institutes in this study. Pediatricians should construct a support program for better management of these patients and for cooperation with cardiologists to prevent loss to follow up.

摘要

背景

对于患有川崎病(KD)后有童年冠状动脉病变(CAL)病史的成年人,讨论医疗保健过渡(HCT)很重要。在日本川崎病协会的支持下进行了一项全国性问卷调查。本研究的目的是阐明KD后CAL患者的HCT现状和失访情况。

方法

2014年5月至7月,通过电子邮件向48名日本川崎病协会成员发送了调查问卷。

结果

共收集到40份调查问卷,回复率为83.3%。65%的受访者来自大学医院。约90%的受访者诊治需要HCT的患者,55%的受访者有完成HCT的患者。约70%的受访者认为儿科医生应继续与心脏病专家分享HCT信息。超过95%的受访者对心脏病专家提供的HCT护理印象良好或一般。HCT失访的受访者比例超过40%。

结论

在本研究中,超过一半的机构中成年心脏病专家开始管理KD后患有CAL的患者。儿科医生应构建一个支持项目,以便更好地管理这些患者,并与心脏病专家合作以防止失访。

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