欠发达地区农村高血压患者规范化管理对其血压水平的干预效果评价

Effects of standardized hypertension intervention on blood pressure level in underdeveloped rural regions

目的探索高血压规范化管理的思路，创新解决欠发达地区农村高血压防治问题。方法以甘肃民勤县为研究现场，采用类试验流行病学方法，并评价患者的收缩压和舒张压水平变化情况。结果试验组血压值在结局期较基线期均有显著降低，试验组血压值降低水平与对照组相比，差异有统计学意义；其干预前后的平均净效益值分别为5．27mmHg（1mmHg=0．133kPa）和3．01m／nHg，而与对照组比较差异无统计学意义；试验组结局期血压控制率较基线期显著提高；试验组收缩压和舒张压在不同随访阶段呈逐渐下降的趋势。结论在欠发达地区农村，以乡镇卫生院医务人员为主导的初级卫生保健力量在高血压规范化管理方案的指导下，通过对高血压患者开展主动的筛查、随访和健康教育，可以有效降低人群的血压水平。

Objective To create new method of resolving the issue of hypertension prevention and control in the underdeveloped regions by exploring the standardized intervention protocol （SIP）. Methods Minqin County in Gansu Province was taken as research field, and health education covered the full population and individual following-up were adopted by quasi-experiment, and finally the changing level and trend of systolic and diastolic blood pressure were evaluated. Results The systolic and diastolic blood pressure of intervention group showed statistically decreasing in final period compared with baseline period, the decreasing level of pressure in intervention group showed statistical significance than that in control group, and the average net effect value of systolic and diastolic blood pressure between before and after intervention are 5.27 mm Hg and 3.01 mm Hg（ 1 mm Hg =0. 133 kPa）, respectively. Moreover, no statistical significance was showed in the control group. And the intervention group had higher blood control rate than the control group, the tendency of blood pressure of intervention group showed an increasing decline in general. Conclusions All these results showed that the active screening, following up and health education, conducted by the primary health care staff of township hospitals, directed by the SIP, can decrease hypertension effectively in the rural area of underdeveloped region of China.