成都市玉林社区高血压患者契约式管理效果分析  

Analyses on the effect of community-based intervention on hypertension

作　　者：赵芳[1] 郑建中[1] 陈博文[2] 谢晓桦[2] 

机构地区：[1]山西医科大学公共卫生学院社会医学教研室,太原030001 [2]首都儿科研究所卫生发展与研究中心

出　　处：《中华流行病学杂志》2003年第10期897-900,共4页Chinese Journal of Epidemiology

摘　　要：目的　对社区高血压患者契约式管理前后相关指标的分析 ,探讨契约式管理模式的可行性。方法　在成都市玉林社区组织“高血压之家” ,对这部分高血压患者实行契约式管理 ,半年后总结干预效果。结果　经过干预 ,高血压患者收缩压 (SBP)和舒张压 (DBP)下降显著 (P <0 .0 5) ,整体血压水平SBP下降了 8.94mmHg( 1mmHg =0 .13 3kPa) ,DBP下降幅度为 3 .61mmHg ,基线血压异常者SBP下降了 14 .0 6mmHg,DBP下降幅度为 5.97mmHg。血压的控制率从 3 8.3 9%上升到64.2 9% ,女性血压控制率显著 (P <0 .0 0 1)。高血压判定标准知晓率由干预前 58.0 6%上升到74.19% ,显著高于干预前 (P <0 .0 1)。高血压危险因素中肥胖和遗传的认识率与干预前相比显著提高 (P <0 .0 5)。Objective To testify the feasibility of m anagement through contract system between general practitioners and patients. Methods In Sichuan province contract was made between ge neral practitioners and hypertension patients in “community health service cen ter—family of hypertension patients” in Yulin community in Chengdu city. After half a year,we analysed the effects of community-based intervention on hy pertension. Results General means of both SBP and DBP remarkably d ecreased ( P< 0.05 ) with SBP remarkably decreased by 8.94 mm Hg while DBP decreased by 3.61 mm Hg . After interfered by the model,people w hose blood pressure were above normal had a remarkable decrease than before by 14.06 mm Hg ( P< 0.05 ). Rates of hypertension being under contr ol increased from 38.39 % to 64.29 % ( P< 0.001 ). Rates of aw areness on fatness and heredity in hypertensive patients were increasing from 58.06 % to 74.19 % ( P< 0.001 ). Rate of awareness on risk fac tors for hypertension was also higher than that of 6 months back ( P< 0.05 ). Conclusion The model of management by signing contract be tween general practitioners and patients in community,proved to be a successful way in the treatment to control high blood pressure.

关 键 词：成都市 玉林社区 高血压 契约式管理 管理模式 

分 类 号：R544.1[医药卫生—心血管疾病]