社区高血压患者综合干预效果评价  

Evaluation of a Community-based Integrated Intervention in Patients with Hypertension

作　　者：张银娥[1] 王晓莉[1] 杨艺[1] 何源[1] 刘凤香[2] 苏弘毅[2] 游淑华 

机构地区：[1]宁夏疾病预防控制中心,银川750004 [2]宁夏平罗县疾病预防控制中心,平罗753400 [3]银川市文化诊所,银川750001

出　　处：《宁夏医科大学学报》2013年第4期407-411,共5页Journal of Ningxia Medical University

基　　金：宁夏科技攻关项目(KGX-13-07-05)

摘　　要：目的对宁夏平罗县社区高血压患者综合干预效果进行评价。方法对自愿参加管理的440例高血压患者进行为期一年的综合干预,分别于干预前后进行问卷调查、体格检查以及血生化分析,比较干预前后高血压患者知晓率、治疗率、控制率、不良生活行为改变率以及血压、血糖、血脂、体重指数等指标。结果干预后高血压患者收缩压和舒张压均值(136.93±16.81和86.19±10.11)均低于干预前(147.01±14.30和91.56±9.43),P<0.001;高血压知晓率(93.86%)、治疗率(92.05%)和控制率(74.95%)较干预前(75.45%、55.91%和44.55%)提高(P<0.001);患者进行低盐饮食、适量运动、体重控制、戒烟、限酒等健康生活方式的比例明显增加,体重、腰围和体质指数降低(P<0.001);总胆固醇和甘油三酯水平均较干预前降低,而高密度脂蛋白较干预前升高(P<0.001)。结论社区医生分级随访管理、患者自我管理、家庭管理和健康宣教等相结合的综合干预措施可以提高高血压患者知晓率、治疗率和控制率,促进患者建立健康生活方式,对高血压患者血压控制效果良好。Objective To evaluate the effect of community - based integrated intervention in patients with hy-pertension in Pingluo County, Ningxia Province. Methods An integrated intervention was administered to voluntary participants （ n = 440 ） over the course of one year. Participants were given a face - to - face survey, a physical examination and a laboratory blood test to compare the following before and after the intervention： level of awareness, treatment adherence, treatment effectiveness, life habits, blood pressure, fasting blood glucose, blood lipid and body mass index （BMI）. Results After the intervention the average systolic blood pressure （SBP） and average diastolic blood pressure （DBP） of participants were significantly decreased from （ 147.01 ± 14.30 and 91.56 ± 9.43 ） to （ 136.93 ± 16.81 and 86.19 ± 10.11 ）, respectively （P 〈 0. 001 ）. The levels of awareness, treatment adherence and treatment effectiveness were significantly increased from 75.45%, 55.91% and 44.55% to 93.86%, 92.05% and 74.95%, respectively （P 〈0.001 ）. The propor-tion of patients who adopted healthy life habits （ eating a low salt diet, exercising regularly, controlling their weight, quitting smoking and limiting alcohol consumption） was also significantly increased （P 〈 0.01 ）. Par-ticipants mean weight, BMI and waistline measurements were significantly decreased after the intervention. With regard to blood lipid indicators： total cholesterol （TC） and total glycerin （TG） were significantly de-creased, and high - density lipoprotein - e （ HDL - c） was significantly increased （P 〈 0.001 ）. Conclu-sion Developing an integrated intervention including follow - up classification management, encouragement of self - management and family management, and promotion of education about hypertension can effectively de-crease blood pressure among persons with hypertension, improve the level of awareness, improve treatment and control of hypertension, and promote a healthy life st

关 键 词：高血压 社区 干预 效果 评价 

分 类 号：R473.2[医药卫生—护理学]