社区高血压患者规范化管理效果评价

Evaluation of effectiveness of standardized management for patients with hypertension in a community

目的探讨对社区高血压患者进行规范化管理的效果,为高血压患者的治疗提供依据。方法 2009年3月到2011年12月在北京市西城区德胜社区6个卫生服务站,对经济收入比较稳定的286例高血压患者进行规范化管理,比较干预前后生活方式、服药依从性、腰围控制情况、高血压治疗率及控制率的变化。结果经3年规范化管理后,高盐饮食(每日食盐量≥8 g)控制率明显提高,差异有统计学意义(χ2=13.319,P<0.05),经常食用奶制品及豆制品率提高(每周食用次数≥5次),差异有统计学意义(χ2值分别为10.024、10.179,P<0.05);与干预前比较,干预后男、女性腰围正常率均提高,但仅女性差异有统计学意义(χ2=15.207,P<0.05);患者血压控制达标率明显提高,差异有统计学意义(χ2=69.764,P<0.01);3年服药依从性比较,差异无统计学意义(P>0.05);高血压药物治疗率干预前后差异无统计学意义(P>0.05)。结论社区高血压患者规范化管理有助于改善患者的生活行为方式、健康状况,提高高血压控制率。

Objective To assess the effectiveness of standardized management of patients with hypertension in a community, and to provide basic data for the treatment of hypertension. Methods A total of 286 hypertension cases with health insurance or free medical care from Health Service Center of Desheng Community in Xicheng District of Beijing during March of 2009 to December of 2010 were served as subjects. After standardized management, the changes of lifestyle, medication compliance, weight control, treatment rate and control rate of hypertension were observed. Results After 3 years of standardized management, the high-salt diet （ ≥8 g a day） control rate of patients significantly enhanced （X2=13.319, P〈0.05）, the regular consumption rate （≥5 times a week） of dairy and bean products significantly enhanced （X2=10.024 and 10.179, P〈0.05）, the waist control rate for females significantly increased （x2=15.207, P〈0.05 ）, the control rate of blood pressure significantly increased （x2=69.764, P〈0.01 ）, there were no significant differences in medication compliance and hypertension treatment rate （P 〉0.05）. Conclusion The standardized management of hypertension patients in community can improve the lifestyle, behaviors, health status and hypertension control rates for patients with stable income, health insurance or free medical care.