北京市怀柔区农村社区高血压综合干预效果观察

The Observation of Comprehensive Intervention Effect for Patients with Hypertension in a Rural Community of Huairou District, Beijing City

目的通过对北京市怀柔区农村社区高血压患者的综合干预效果观察,探讨农村社区高血压防治模式。方法于2006年对怀柔某农村社区经基线调查确诊的高血压患者进行为期1a的社区综合干预(健康教育、行为干预、药物治疗和定期随访等),对患者进行干预前、后问卷调查和医学体检,评价其干预效果。结果参加社区高血压综合干预的高血压患者193例,其中男性84例,女性109例,平均年龄(57.61±10.24)岁。在高血压诊断标准、危险因素、主要损害器官、高血压不能根治、服降压药感觉良好后仍需坚持用药等知识知晓率方面干预前后差别均有统计学意义(P<0.05)。对控制体重、限制食盐、增加运动、限制饮酒、戒烟等非药物治疗的使用率均上升,除戒烟外,其余干预前后差别有统计学意义(P<0.01)。干预后高血压患者复查率、药物治疗率和控制率较干预前分别提高了10.88%,6.74%和10.37%,其中干预前后复查率和控制率差别有统计学意义(P<0.05)。结论针对农村社区高血压患者健康状况,对患者进行定期随访、改变不良生活习惯、开展健康教育等社区高血压综合干预,对提高患者高血压知识知晓率、非药物治疗依从性及血压控制率等具有重要意义。

Objective To evaluate the effect of comprehensive intervention to patients with hypertension in a rural community of Huairou district of Beijing. Methods 193 hypertension patients were screened out from a rural community of Huairou area, Beijing city in 2006, and they were all given a 1-year comprehensive intervention, including health education, behavior intervention, medication treatment and periodical follow-up. Questionnaire survey and physical examination were done before and at the end of the comprehensive intervention. Results Among the 193 hypertension patients, there were 84 males and 109 females; their average age was（57.61±10.24） yrs. There were significant differences in the awareness rates of the diagnosis standard for hypertension, its risk factors, mainly organs damage, hypertension being hard to cure, and insisting on long term medication treatment even after feeling better with antihypertensive drugs （P〈0.05）. At the end of the intervention, the utilization rates of non- medication treatments, including the body weight controlling, salt ＆ alcohol restriction, increase in physical exercise, and smoking cessation, etc., were increased and significantly different than those at the beginning of the intervention except the rate of the smoking cessation （P〈0.01）. After the intervention, the total reexamination rate, the total medication treatment rate and the total control rate of the patients with hypertension were enhanced by 10.88%, 6.74% and 10.37%, and they were significantly different than those before the intervention（P〈0.05）. Conclusion For the health status of the patients with hypertension in rural community, it is very important for them to enhance the awareness rate of the hypertension knowledge, compliance to the non-medication treatments and hypertension control by taking periodical follow-up, changing their unhealthy habits and customs and taking the health education, etc.