团队规范化管理社区高血压患者的效果观察

Effect of standardized management of hypertension patients in community

目的观察社区高血压患者经过团队规范化管理后的临床效果,并对其进行评价。方法选取社区内50~60岁的常住居民为调查对象,调查时间为2016年1月至2017年1月。由淮南市第一人民医院专业医师接受规范化培训后,统一开展调查。抽取符合条件的确诊高血压患者160例,其中男91例,女69例。按照随机数字表法分为对照组和干预组,对照组采用常规社区护理方式,干预组通过社区团队规范化管理的方式进行干预,干预期限1年,期间进行定期随访,对居民接受干预前后的血压及知晓率变化情况进行对比分析。结果随访1年后,对照组高血压患者的知晓率、服药率、控制率(85.0%、77.5%、47.5%)均高于管理前的"三率"水平(57.5%、53.8%、28.8%)。干预组高血压患者的"三率"指标(100.0%、92.5%、68.8%)与管理前(58.8%、56.2%、31.3%)相比均有所提高。且干预组的"三率"指标显著高于对照组(χ^2=12.973、7.059、7.421,均为P<0.05)。与此同时,干预组的血压降低情况显著优于对照组[舒张压:(98.7±16.4)mmHg/(78.5±11.7)mmHg,t=5.42,P<0.05;收缩压:(161.2±10.6)mmHg/(130.6±12.1)mmHg,t=-5.31,P<0.05],差异有统计学意义。结论社区高血压患者应用团队规范化管理,干预效果显著优于常规社区护理方式,可以有效降低血压,提高知晓率。

Objective To investigate the effect of standardized management of hypertension patients in community.Methods Permanent residents aged 50-60 in the community were selected as the survey subjects from January 2016 to January 2017.After the standardized training of professional doctors in the First People's Hospital of Huainan,a unified investigation was carried out.A total of 160 qualified hypertensive patients were selected,including 91 males and 69 females.According to the random number table method,the patients were divided into the control group and the intervention group.The control group was given routine community nursing,and the intervention group was given standardized community team management,and the intervention period was 1 year.The changes of blood pressure and awareness rate before and after intervention were compared and analyzed.Results Through standardized management of the team,the awareness rate,medication rate and control rate(85.0%,77.5%,47.5%)of the control group were higher than those before management(57.5%,53.8%,28.8%).The"three rates"of hypertension patients in intervention group(100.0%,92.5%,68.8%)were higher than those before management(58.8%,56.2%,31.3%).Moreover,the awareness rate,medication rate and control rate of the intervention group were significantly higher than those of the control group(χ^2=12.973,7.059,7.421,all P<0.05).Meanwhile,the DBP and SBP of the intervention group were significantly lower than those of the control group[DBP:(98.7±16.4)mmHg vs.(78.5±11.7)mmHg,t=5.42,P<0.05;SBP:(161.2±10.6)mmHg vs.(130.6±12.1)mmHg,t=-5.31,P<0.05].Conclusion The effect of standardized management of hypertension patients in community is better than traditional community nursing,which can effectively reduce blood pressure and improve the awareness rate,and is suitable for clinical application.