健康查体后综合干预及定期随访对原发性高血压患者的影响  

Influence of comprehensive intervention and regular follow-up on primary hypertension patients afterhealth examination

作　　者：邢翠珍 崔月丽 闰和美 

机构地区：[1]山东省青岛疗养院人力资源部,266071 [2]山东省青岛疗养院护理部,266071 [3]山东省青岛疗养院病区,266071

出　　处：《中华现代护理杂志》2012年第35期4217-4222,共6页Chinese Journal of Modern Nursing

基　　金：山东省卫生厅基金资助项目（2007HW132）

摘　　要：目的探讨综合干预、定期随访对健康体检中诊断为原发性高血压患者的高血压知晓率、治疗率、控制率及其并发症发生率的影响。方法选择2007年1月至2009年1月在健康体检中心体检时确诊为原发性高血压的患者1183例，按照分层随机分组法分为干预组587例和对照组596例。对照组在入组后进行1次健康教育，之后由患者自行管理，对治疗和行为不做要求，每年进行1次随访。干预组给予定期随访及综合性治疗干预措施（包括药物和非药物），按评估→计划→实施→评价4个基本步骤循环进行，定期跟踪随访3年。结果综合干预3年后，干预组高血压治疗率和控制率（分别为89．8％，69．5％）明显高于对照组（分别为36．4％，22．1％），组间差异有统计学意义（X^2值分别为360．92，267．34；P均〈0．01）；干预组饮食控制、参加体育活动、限酒和戒烟者的比率（分别为68．5％，71．9％，88．9％，87．4％）均高于对照组（分别为37．2％，58．2％，49．3％，66．9％），组间差异有统计学意义（妒值分别为117．94，30．62，220．62，71．18；P均〈0．01）；干预组胆固醇、甘油三酯、血糖、血清肌酐和BMI值[分别为（4．34-0．7）mmol／L，（1．52±0．5）mmol／L，（5．3±0．8）mmol／L，（93．2±12．5）p．mol／L，（23．7±4．4）kg/㎡]均低于对照组[分别为（4．9±0．4）mmol／L，（1．76±0．6）mmol／L，（5．7±0．7）mmol／L，（99．54-15．8）moL／L，（26．6±4．8）kg／㎡]，组间差异有统计学意义（t值分别为18．134，7．468，9．156，7．598，10．828；P均〈0．05）。结论实施个性化药物及非药物综合干预措施，可以降低各种危险因素，提高原发性高血压患者对保健知识的认知度，纠正不良行为方式和生活习惯，减轻心理压力和紧张情绪，提高患者的药物依从性，从而提高对高血�Objective To explore the influence of comprehensive intervention and regular follow-up on hypertension awareness, treatment rate, control rate and its complications incidence rate of the patients who were diagnosed as primary hypertension in physical examination. Methods Selected 1 183 cases that were diagnosed as primary hypertension in our health examination center from January 2007 to January 2009, which were divided into the intervention group （ n = 587 ） and the control group （ n = 596） randomly. The control group was given a health education at the first, then the patients managed themselves, their treatment and behavior were not required, and we followed them annual. The intervention group was given regular follow-up and comprehensive treatment intervention （including drug and non-drug）, we followed the four basic steps that assessment→plan→ implementation→evaluation in circulation, and regular followed-up for 3 years. Results After 3 years, hypertension treatment rate and control rate in the intervention group （89.8%, 69.5% ） was higher than that in the control group （36.4% , 22.1% ） , and the difference was statistically significant （~2 = 360.92, 267.34, respectively; P 〈 0. O1 ）. The ratio of diet control, participate in sports activities, wine limited and smoking cessation in the intervention group （68.5% , 71.9%, 88.9% , 87.4% ） were higher than those in the control group （37.2%. 58.2%. 49. 3%. 66.9% ）. and the differences between the two groups were statistically,significant （X2 = 117. 94, 30. 62, 220. 62, 71. 18, respectively; P 〈 0. 01 ）. The values of cholesterol, triglycerides, blood glucose, serum creatinine, and BMI in the intervention group [ （4.3± 0.7）mmol/L, （ 1.52 ±0.5） mmol/L, （ 5.3 ± 0.8） mmol/L, （93.2 ＋ 12.5 ） mol/L, （ 23.7 ＋ 4.4） kg/m2 ] were lower than those in the control group [ （4.9 ±0.4） retool/L, （ 1.76 ± 0.6） mmol/L, （5.7 ＋ 0.7 ） retool/L, （99.5 ± 15.8 ） mol/L, （26.6±4.8） kg/m2 ], a

关 键 词：高血压 综合干预 定期随访 疾病控制 

分 类 号：R544.1[医药卫生—心血管疾病]