全程护理干预在控制老年人心血管疾病危险因素中的应用效果

Effect of Nurse Case Management in control of Cardiovascular Risk Factors in old people

目的:比较全程护理干预与普通保健对具有心血管危险因素的老年人血压、血糖及血脂方面的疗效。方法:选择具有心血管危险因素或心脑血管疾病病史的老年人,按照是否进行全程护理分为干预组和对照组,比较随访12月后的血压、血糖及血脂达标情况。结果:干预组153例,对照组115例。干预组血压、血糖及血脂达标率12月末高于基线,差异均有统计意义,对照组三项指标达标率12月和基线情况相比差异无统计意义。干预组和对照组相比,血压达标率的OR和95%CI分别为1.25(1.10～1.59,P=0.023),HbA1c达标率的OR为1.34(95%CI为(1.11～184.67),P=0.025),LDL达标率对应OR为1.30(95%CI为(1.07～1.67),P=0.031)。结论:对具有心血管危险因素的老年人,12个月的全程护理干预可更有效使血压、血糖及血脂达标。

Objective To determine whether nurse case management could effectively improve rates of control for hypertension, hyperglycemia,and hyperlipidemia compared with usual care among old people. Methods A retrospective study of patients （age〉60 years） with high cardiovascular risk factors.lntervention patients received case management （n=153） versus usual care （n=115）over a 1-year period.The primary outcome was the percentage of patients achieving simultaneous control of all three parameters. Results 12 months later,the intervention group achieved the individual treatment goals of HbAlc,BP and LDL.The compare group do not have significant changes.Compare to the usual group, the OR and 95%CI of BP＇s achievment rate in the control group are1.25 （1.10-1.59, P=0.023, HbAlc＇s OR and 95%CI are 1.34 （1.11-184.67）, P=0.025;LDL＇s OR and 95%CI 1.30 （1.07-1.67）, P=0.031. Conclusions In old people, nurse case managers can effectively improve the number of individuals with control of multiple cardiovascular risk factors at 1 year.