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摘要：
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摘要：目的 在现行肝硬化并发症二级预防规范下，探讨长期主动随访管理模式对肝硬化并发症预防
效果的影响。方法 选取2013年7月至2016年10月于首都医科大学附属北京地坛医院接受治疗的乙型肝
炎肝硬化患者为研究对象，采用随机数字表法将患者分为试验组和对照组。在现行肝硬化并发症二级
预防规范基础下，试验组实施长期主动随访管理模式干预，由专人进行门诊随访（随访医师为肝病内
科主治医师/副主任医师3～5人）；对照组依据患者意愿选择肝病中心资深医师（均为副主任医师以
上职称）进行门诊随访。编制病例报告表（case report form，CRF），培训调查员（为肝病专业临床
研究生），应用医院信息系统（hospital information system，HIS）对上述2组患者的就诊信息进行跟
踪记录，随访时间为2年。评价两种门诊随访操作规范的远期效果。结果 共纳入乙型肝炎肝硬化患者
163例，其中试验组83例，对照组80例。两组患者在为期2年的随访过程中，肝硬化并发症再发生率
（χ 2 = 11.823，P = 0.002）、再住院率（χ 2 = 19.862，P ＜ 0.001）、2年内的人均住院时间（z = 2.049，
P = 0.040）、人均年医疗费用（仅统计肝病治疗费用）（z = 3.121，P = 0.001）等差异有统计学意
义。结论 应用长期主动随访管理模式干预，有利于提高肝硬化并发症的管控，降低肝硬化并发症的
再发生率和再住院率，改善患者生存质量，减少医疗费用支出。
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Abstract: Objective To investigate the effects of long-term active follow-up management on the prevention
of complications of liver cirrhosis based on the secondary prevention of liver cirrhosis. Methods Patients
with hepatitis B and liver cirrhosis in Beijing Ditan Hospital, Capital Medical University from June 2013 to
October 2017 were selected and randomly divided into two groups according to the random number table
method. On the basis of the secondary prevention of liver cirrhosis, long-term active follow-up management
intervention was performed in treatment group, and the outpatient follow-up was conducted by special
person (the following-up physicians were the attending physician / deputy chief physician in Liver Diseases
Department, 3～5 persons). In control group, senior physicians, all of whom were deputy chief physician
above and from the Department of Liver Diseases were selected according to the patients’ wishes to conduct
outpatient follow-up. Case report forms (CRF) were prepared and the investigators were trained (clinical
graduate students of liver diseases). Hospital information system (HIS) was used to track and record the
information of patients in two groups, and the patients were followed up for two years. The long-term effects
were compared and furtherly analyzed between the two groups. Results A total of 163 patients with hepatitis
B and liver cirrhosis were enrolled, including 83 in the treatment group and 80 in the control group. After
two years following up, the recurrence rate of complications of liver cirrhosis (χ 2 = 11.823, P = 0.002), the rate
of rehospitalization (χ 2 = 19.862, P ＜ 0.001), the average time of hospital stay in two years (z = 2.049，P =
0.040), the per capita annual medical costs (z = 3.121，P = 0.001) of patients in treatment group were lower
than those in control group. Conclusions Long-term active follow-up management intervention can improve
the management of complications of liver cirrhosis, reduce the recurrence rate of complications and the rate
of rehospitalization, improve the quality of life of patients and reduce the medical costs.
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