定点健康咨询在社区儿童疾病预防中的应用效果研究

Application effect of fixed-point health counseling in community children diseases prevention

目的探讨儿童高血压社区定点咨询中应用定点健康咨询服务模式的效果及对其应用价值。方法某社区于2011年1月至2013年1月对儿童高血压患者实施定点健康咨询服务管理模式(研究阶段),于2009年1月至2010年12月实施常规性管理(对照阶段),观察不同管理方式对社区儿童高血压患者血压控制情况、儿童高血压筛查率、管理效果及并发症发生率的影响。结果研究阶段儿童高血压首诊率为3.39%,对照阶段儿童高血压首诊率为5.18%,差异有统计学意义(P<0.05)。研究阶段血压控制不良率(9.46%)、急性事件发生率(4.05%)均显著低于对照阶段(分别为26.08%、14.49%),差异有统计学意义(P<0.05)。观察阶段缺乏运动、吸烟、高盐饮食、酗酒等危险因素引起的儿童高血压发生率显著低于对照阶段(P<0.05)。结论社区医生对儿童高血压患者实施定点健康咨询管理模式可连续、全程地对患者进行管理,提高患者治疗依从性,有利于社区儿童高血压的管理。

Objective To investigate the effect and application value of the fixed‐point health counseling serv‐ice mode in children hypertension community fixed‐point conseling .Methods The children with hypertension in a community from January 2011 to January 2013 were implemented the service management mode of the fixed‐point health counseling（study period） and implemented the conventional management period（control period） .The influence of different management modes on the blood pressure controlling situation ,screening rate of children hypertension , management effect and occurrence rate of complications were observed .Results The initial diagnosis rate of children hypertension in the study period was 3 .39% ,which in the control period was 5 .18% ,the difference was statistically significant（P〈 0 .05） .The poor rate of blood pressure control in the study period was 9 .46% and the occurrence rate of acute events was 4 .05% ,which were significantly lower than 26 .08% and 14 .49% in the control period ,the differences were statistically significant（P 〈 0 .05） .The occurrence rate of children hypertension caused by the risk factors of lack of exercises ,high salt diet ,alcoholism ,etc was significantly lower than that in the control period ,the difference was statistically significant（P 〈 0 .05） .Conclusion Community physicians implementing the fixed‐point health counseling mode on the children patients with hypertension can conduct the continuous and whole course man‐agement ,increases the patient′s treatment compliance and is conducive to the management of community children hy‐pertension .