上海市奉贤区头桥社区高血压综合干预效果分析

Effect of comprehensive intervention on hypertension in Touqiao community of Fengxian district in Shanghai

目的分析和评价以社区为基础的综合管理干预对高血压患者在本病相关知识、态度、行为及血压控制效果等方面影响,为进一步做好社区高血压管理工作提供参考。方法随机抽取2015年3月—2016年5月头桥社区的两个居委35岁以上高血压患者200例,其中8例失访,分析其在实施综合管理前后高血压相关知识、态度、行为以及血压控制率等指标变化,评价干预效果。计数资料比较采用χ~2检验,计量资料比较采用U检验,P<0.05为差异有统计学意义。结果干预后,病人对高血压诊断标准、并发症以及吸烟、酗酒、肥胖、高盐饮食等危险因素知晓率提高10.9%~25.5%(均P<0.05);对戒烟、控酒、控盐、控制体重和控制情绪等非药物干预措施执行率提升12.5%~15.7%(均P<0.05);对定期测血压和药物治疗等规范诊疗行为执行率提升32.4%和10.4%(均P<0.05);收缩压和舒张压下降23 mm Hg和11 mm Hg,血压控制率提升32.8%(均P<0.05)。结论社区高血压综合管理措施有助于提升高血压患者的自我管理水平,有效预防和控制高血压的发生和进展。

Objective To explore the influence of community-based hypertension comprehensive management intervention on hypertension related knowledge, attitude, behavior and blood pressure control effect in hypertension patients, and to provide reference for further community hypertension management.Methods A total of 200 hypertension patients over 35 years old in the two residential committees in the Touqiao community from March 2015 to May 2016 were randomly selected.8 cases lost follow up. The changes of hypertension related knowledge, attitude, behavior and blood pressure control rate were analyzed before and after the implementation of comprehensive management, and the effect of intervention was evaluated.Count data were compared by χ^2 test,and measurement data were compared by U test,P0.05 was considered statistically significant.Results After the intervention, the awareness rate of risk factors for hypertension, such as diagnostic criteria, complications, smoking, alcoholism, obesity and high salt diet increased by 10.9%～25.5%（all P〈0.05）. The implementation rate of non-drug intervention measures such as smoking cessation, alcohol control, salt control, weight control and emotional control increased by 12.5% to 15.7%（all P〈0.05）.The implementation rate of standardized diagnosis and treatment of blood pressure and medication was increased by 32.4% and 10.4%（all P〈0.05）.Systolic and diastolic pressure decreased by 23 mm Hg and 11 mm Hg, and the control rate of blood pressure was increased by 32.8%（all P〈0.05）.Conclusion The comprehensive management measures of community hypertension can help to improve the self-management level of hypertension patients,and effectively prevent and control the occurrence and progress of hypertension.