计算机辅助分层诊疗模型对提高H型高血压控制率的研究  

Study on Computer Aided Layered Diagnosis and Treatment Model on Improving the Control Rate of Type H Hypertension

作　　者：卢星杉 赵涛[1] 代维斯 LU Xing-shan; ZHA O Tao; DAI Wei-si(Fuling Central Hospital, Chongqing, 408000 China)

机构地区：[1]重庆市涪陵中心医院,重庆408000

出　　处：《中国卫生产业》2018年第29期173-175,共3页China Health Industry

基　　金：计算机辅助分层诊疗模型对提高H型高血压控制率的研究(2015XMSB000926)

摘　　要：目的分析计算机辅助分层诊疗模型对提高H型高血压控制率的效果。方法以重庆市涪陵中心医院2015年7月—2016年7月在H型高血压门诊就诊的H型高血压患者1 198例入组,按照病例纳入标准入组及登记,进行实验室检查、量表评估,根据患者门诊测量的血压控制情况,分析血压控制的影响因素,采用PDCA四步法创建计算机辅助分层模型。分析每一位患者的血压无法控制的风险(OR),根据分层采取不同的管理干预策略,根据干预的方法、风险因素分布情况,安排相应的管理干预。6个月后进行复查。结果管理后血压管理分层显著下降,血压控制率79.8%高于管理前47.7%,差异有统计学意义(P<0.05)。管理后,社会支持度评分、用药依从性评分高于管理前,脑卒中危险因素个数、焦虑评分、抑郁评分低于管理前,差异有统计学意义(P<0.05)。治疗期间,出现1例脑出血、13例脑梗死,10例全因死亡。管理前模型对血压控制预测灵敏度87.8%(502/572)、特异度83.5%(523/626)、符合率85.6%(1 025/1 198),管理后模型对血压控制预测灵敏度86.2%(824/956)、特异度86.8%(210/242)、符合率86.3%(1034/1198)。结论计算机辅助分层诊疗模型明显提高H型高血压控制率;模型对于血压控制的预测效果较好,可作为分层管理的依据。Objective To analyze the effect of computer aided layered diagnosis and treatment model on improving the control rate of type H hypertension. Methods 1 198 cases of patients with type H hypertension admitted and treated in our hospital from July 2015 to July 2016 were selected and registered for laboratory examination and scale evaluation, and the blood pressure control condition of outpatient measures of patients was used to analyze the influencing factors of blood pressure control, and the computer aided layered diagnosis and treatment model was created by the PDCA four step method, to analyze the OR of each patient, and the corresponding management intervention was arranged according to different management intervention strategies, intervention method and risk factors. And the patients were reexamined after six months. Results The blood pressure management layer after management obviously decreased, the blood pressure control rate was higher than that before management（79.8% vs 47.7%）, and the difference was statistically significant（P〈0.05）, after management, the social support degree score and medication compliance score were higher than those before management, and the number of risk factors, anxiety score, and depression score of stroke were lower than those before management, and the differences were statistically significant（P〈0.05）,during the treatment, there was 1 case with cerebral hemorrhage, 13 cases with cerebral infraction, and 10 cases died, and the sensitivity degree of model to the blood pressure control, specificity, coincidence before and after management were respectively 87.8%（502/572）,83.5%（523/626）, 85.6%（1 025/1 198） and 86.2%（824/956）,86.8%（210/242）,86.3%（1 034/1 198）. Conclusion The computer aided layered diagnosis and treatment model can obviously improve the H type hypertension control rate, which has a better predicative effect on the blood of blood pressure, which can be used as the basis for the layered management.

关 键 词：H型高血压 血压控制率 分层诊疗模型 

分 类 号：R544.1[医药卫生—心血管疾病]