某营区高血压患者基层门诊5年管理效果分析  

Analysis of 5-year management effects of hypertensive patients in grassroot outpatient clinic in a military camp

作　　者：马江华 谭晓丽 张晓莉 王丽[2] 董明月 王卓 

机构地区：[1]解放军火箭军总医院清河门诊部 [2]济南军区青岛第一疗养院一区 [3]解放军96819部队门诊部

出　　处：《中国现代医生》2016年第18期121-124,共4页China Modern Doctor

摘　　要：目的分析高血压的基层门诊管理效果,总结对高血压的有效防治措施。方法选择某营区≥28岁的人群,以2010年1月在营区常住人口中被明确诊断为高血压的326例患者为对象,由门诊负责对患者采取规范化的5年分级管理,包括血压水平、危险度评估、健康教育、改变不良生活习惯、自我管理、药物治疗以及制定个体化的随诊诊疗方案等,并于2014年12月对相关资料进行自身前后比较。结果采取规范化的5年分级管理后,高血压患者的健康行为明显改善,尤其是在自我监测血压、运动、健康知识知晓率、控制饮食、规律服药方面较管理前改善明显,差异有统计学意义(P<0.05);患者的收缩压、舒张压分别由干预前的(159.45±12.78)mm Hg、(98.53±8.19)mm Hg降至干预后的(126.19±8.84)mm Hg、(81.03±7.37)mm Hg,血压控制率提高了46%,差异有高度统计学意义(P<0.01);患者的血糖、血脂、血尿酸、体重指数等代谢指标控制均明显优于干预前,差异有高度统计学意义(P<0.01)。结论建立以基层门诊为基础的高血压综合防治基地,可有效监控并减少高血压相关危险因素,有效降压,降低心血管事件发病率和死亡率,具有可行性和有效性,有积极推广应用价值。Objective To analyze the management effects of hypertension in grass-root outpatient clinic, and to sum- marize effective prevention and treatment measures for hypertension. Methods The people with the age of ≥28 in a military camp were selected, and 326 clearly diagnosed hypertensive patients among cadres, sergeancy, staff and family members in January 2010 were selected as subjects. The management was carried out for 5 years, including blood pres- sure level, evaluation of lisk degree, health education, improvement of negative life habits, self-management, medical treatment and formulation of individualized follow-up therapeutic protocol. Related data were self-compared before and after the management in December 2014. Results After the standardized 5-year level-to-level management by the out- patient clinic, the health behavior of hypertensive patients was improved significantly, especially self-monitoring blood pressure, physical exercise, awareness rate of health knowledge, diet control and regular taking medication were signifi- cantly improved compared with those before the management, and the differences were statistically significant （P〈0.05）; The systolic pressure and diastolic pressure were reduced from （159.45±12.78） mmHg, （98.53±8.19） mmHg before the intervention to （126.19±8.84） mmI-Ig, （81.03±7.37） mmHg after intervention.The control rate of blood pressure was im- proved by 46%, and the difference was statistically significant（P〈0.01）;The control of metabolic indicators such as blood sugar, blood lipid, blood uric acid and BMI was significantly better than that before the intervention （P〈0.01）.Conclu- sion Establishment of grass-root outpatient clinic-based comprehensive prevention and control base of hypertension is able to effectively monitor and reduce related risk factors for hypertensive patients, effectively reduce blood pressure, and reduce the incidence rate and mortality rate of cardiovascular events, which has feasibility and efficacy and is wor- th

关 键 词：高血压 基层门诊 自我管理 健康知识知晓率 

分 类 号：R544.1[医药卫生—心血管疾病]