主动干预对五保对象老人高血压管理效果研究  

Active Intervention Effect on Hypertension Management for the Elderly with Five-guarantees

作　　者：李华斌 邓春妮 石远琴 肖生兰 徐伟 黄豫军 LI Huabin;DENG Chunni;SHI Yuanqin;XIAO Shenglan;XU Wei;HUANG Yujun(Chongqing Thirteen Peoples Hospital Yongchuan District Branch,Yongchuan 402160,Chongqing Province,China;Chongqing Yongchuan Civil Affairs Bureau,Yongchuan 402160,Chongqing Province,China)

机构地区：[1]重庆市第十三人民医院永川分院,重庆永川402160 [2]重庆市永川区民政局,重庆永川402160

出　　处：《预防医学情报杂志》2020年第3期303-308,共6页Journal of Preventive Medicine Information

基　　金：重庆市永川区自然科学基金资助项目:五保对象高血压患者新型管理办法临床观察(项目编号:2018nb0222)。

摘　　要：目的探寻针对五保老人这一特殊人群的高血压管理的有效途径,提高其生存质量、降低疾病负担。方法对重庆市永川区5家敬老院的五保对象中随机抽取100名老年高血压病患者,以每个组50人随机分为观察组与对照组。对观察组开展低盐低脂饮食、发放药品敦促服药、规律锻炼与健康行为等针对性高血压管理措施,观察并随访对照组与观察组人员47周,收集其一般信息及血压、服药情况、不良症状等相关信息。定量资料采用均数±标准差形式表示,均数、率的比较采用t检验、χ~2检验,以P<0.05为差异有统计学意义。结果对五保老人这一特殊人群,通过有针对性的高血压管理能有效改善其血压控制情况。与对照组相比,干预组五保老人低盐低脂饮食率(100%)与保持运动率(92%~100%)更高,服药依从性47周每周随访均保持在94%~97.96,高于对照组(0%)(P<0.05)。干预组老人血压控制率(96.65%)大于对照组(0%)(χ~2=87.30,P<0.05)。经过血压控制、促进健康饮食与规律运动,干预组不良症状发生率(2%~8%)低于对照组(2%~36%),此外心电图异常率(32.61%)低于对照组(85.71%),肾功能异常率(2.17%)低于对照组(30.61%)。干预组老人随访期间住院率为35%,对照组老人随访期间住院率为48%,干预组五保老人住院率低于对照组(P<0.05)。结论主动干预措施能克服五保老人这类特殊人群因收入与文化水平较低、社会人际支持体系欠缺而不能积极进行生活方式调整和规律服药的难点,可提高其生存质量,降低疾病带来的社会负担。objective To explore an effective way to manage hypertension in the elderly with fiveguarantees so as to improve their quality of life and reduce the disease burden. Methods A total of100 hypertensive patients were randomly selected from the elderly with five-guarantees groups in 5 nursing homes in Yongchuan district. 50 patients were randomly divided into the observation group. For the observation group, targeted hypertension management measures such as low-salt and lowfat diet, drug distribution and urged to take medicine, regular exercise and healthy behaviors were carried out. The control group and the observation group were observed and followed up for 47 weeks to collect their general information,blood pressure, medication status, adverse symptoms and other relevant information. The quantitative data were presented as mean ± standard deviation. The comparison of mean and rate between two groups were performed by t test and χ~2 test, respectively. P<0.05 was considered as statistically significant. Results The blood pressure control of the elderly with five-guarantees can effectively improve by the targeted hypertension management. Compared with the control group,the intervention group had higher rate of low-salt and low-fat diet(100%). Further, the intervention group have higher conservation rate of exercising. The medication compliance of the intervention group was all above 90%(94.0~97.96%),which was higher than those of the control group(P<0.05). The control rate of blood pressure in the intervention group was higher than that in the control group (χ~2=87.30,P<0.05). After the intervention,the incidence of adverse symptoms in the intervention group was lower than that in the control group(P<0.05). Further, the abnormality rate of ECG(32.61%) in the intervention group was lower than that in the control group(85.71%). The renal abnormality rate(2.17%) in the intervention group was lower than that in the control group(30.61%). The hospitalization rate of the elderly in the intervention group during follo

关 键 词：五保对象老人 高血压管理 干预效果 

分 类 号：R544.1[医药卫生—心血管疾病]