尼阿氢卡结合社区卫生定向服务模式对不同年龄段高血压患者的综合干预效果研究

Effect of Comprehensive Intervention of NAHC and Community-Oriented Primary Care Combined Program on Hypertension Patients with Different Ages

目的探讨尼阿氢卡(NAHC)结合社区卫生定向服务(COPC)模式对不同年龄段高血压患者的综合干预效果。方法对桂林市秀峰区4个居委会的631例高血压患者进行NAHC结合COPC模式干预(干预组),另外4个居委会的677例高血压患者单用NAHC干预(对照组),干预时间为1年,进行高血压综合干预效果的比较分析。结果与对照组比较,干预组对6个高血压相关知识点的知晓率、治疗总有效率及显效率均较高,很高危者的比例较低;其中≥50岁年龄段中干预组的总有效率及显效率明显高于对照组,很高危、高危者的比例明显较低;<50岁年龄段中仅很高危者的比例低于对照组,差异均有统计学意义(P<0.05)。对照组中<50岁年龄段患者对4个知识点的知晓率高于≥50岁年龄段者,差异均有统计学意义(P<0.05);但干预组两个年龄段患者对所有8个知识点的知晓率间差异均无统计学意义(P>0.05)。结论NAHC结合COPC模式较单用NAHC干预对社区高血压患者有更好的临床疗效,特别是对≥50岁年龄段患者效果更明显。

Objective To evaluate the efficacy of NAHC program combined with community - oriented primary care （COPC） in the treatment of hypertension patients. Methods NAHC program combined with COPC model was applied to 631 hypertension patients from 4 communities of Xiufeng District of Guilin （ NAHC ＋ COPC group） and NAHC program alone was applied to 677 hypertension patients from other 4 communities of the same district （ control group）. The intervention period was 1 year. The efficacy of the comprehensive intervention in the two types of hypertension treatments was evaluated. Results Compared with the control group, patients in the NAHC ＋ COPC group had higher rates of awareness on 6 hypertension - related issues, higher rates of total efficacy and apparent efficacy, as well as lower percentage of very high risk patients. The rates of total efficacy and apparent efficacy in patients aged≥50 were notably higher, and the percentages of very high and high risk were evidently lower. But, the percentage of very high in patients aged 〈 50 was evidently lower （ P 〈 0.05 ）. In the control group, pa- tients aged 〈 50 had better awareness rates on 4 hypertension - related issues than those aged ≥50 （ P 〈 0. 05 ）. While in the NAHC ＋ COPC group there was no significant difference in the awareness on all 8 hypertension - related issues between patients aged 〈 50 and patients aged ≥50 （P 〉 0. 05）, Conclusion NAHC program combined with COPC model has better clinical efficacy than NAHC alone in the treatment of hypertension patients in community, especially for those aged≥50.