基于“互联网+”院外管理对台州地区高血压脑病患者血压变异性的影响

Effect of"Internet+"management on blood pressure variability of hypertensive encephalopathy in Taizhou

目的探究基于“互联网+”院外管理对急诊高血压脑病患者的干预效果,为改善高血压脑病的院外管理提供有效方法。方法选择2017年1月—2018年8月于台州市中心医院住院治疗并在远程医疗中心注册的急诊高血压脑病患者116例作为研究对象,按照随机数字表法分为观察组和对照组,各58例。对照组采用院内常规护理结合院外定期随访,观察组在对照组基础上应用基于“慢健康”互联网平台的院外管理,比较2组护理干预12个月后24小时平均收缩压(SBP)、舒张压(DBP)、血压变异性(BPV),利用护理工作者自行设计的调查问卷评价患者治疗依从性和护理满意度。结果观察组无失访,对照组2例无应答,最终纳入114例,其中观察组58例,对照组56例。干预后,观察组24小时平均SBP、DBP均低于对照组(均P<0.05)。观察组24小时SBP BPV为(10.20±2.13)mm Hg(1 mm Hg=0.133 kPa),对照组为(16.64±4.36)mm Hg,差异有统计学意义(t=10.073,P<0.05);观察组24小时DBP BPV为(5.26±1.06)mm Hg,对照组为(7.44±1.35)mm Hg,差异有统计学意义(t=9.614,P<0.05)。观察组依从优良率为81.04%,远高于对照组的44.64%(χ^2=16.216,P<0.05)。观察组护理满意度为96.55%,对照组满意度为66.08%,差异具有统计学意义(χ^2=17.614,P<0.05)。结论基于“慢健康”互联网平台的院外管理能够有效控制高血压脑病患者血压水平,稳定血压变异性,提高患者依从性和护理满意度。

Objective To explore the effect of " Internet + " management on emergency hypertensive encephalopathy patients,and to provide effective methods for improving out-of-hospital management of hypertensive encephalopathy. Methods One hundred and sixteen patients with emergency hypertensive encephalopathy who were hospitalized and registered in telemedicine center from January 2017 to August 2018 were selected. According to the random number table method,they were divided into the study group( 58 cases) and the control group( 58 cases). The control group received routine nursing in hospital and regular follow-up visits outside the hospital. The study group was based on " slow health" Internet platform on the basis of the control group. The mean systolic blood pressure( SBP),diastolic blood pressure( DBP) and blood pressure variability( BPV) of the two groups were compared for 12 months. Results There was no loss of followup in the study group,and 2 cases in the control group did not respond,and 114 cases were finally included,including58 cases in the study group and 56 cases in the control group. For 12 months,the level of SBP and DBP in the study group were lower than those in the control group( all P < 0. 05). The 24-hour SBP BPV in the study group was( 10. 20 ±2. 13),and that of the control group was( 16. 64 ± 4. 36),the difference was statistically significant( t = 10. 073,P <0. 05). The 24-hour DBP BPV in the study group was( 5. 26 ± 1. 06),and that of the control group was( 7. 44 ±1. 35),and the difference was statistically significant( t = 9. 164,P < 0. 05). The excellent and good compliance rate of the study group was 81. 04%,much higher than that of the control group( 44. 64%),χ2= 16. 216,P < 0. 05. The satisfaction rate of the study group was 96. 55%,and that of the control group was 66. 08%( χ2= 17. 614,P < 0. 05).Conclusion Based on the " slow health" Internet platform,hypertensive encephalopathy can effectively control blood pressure level,stabilize blood pressure variability,improve patient compliance and nursing satisfaction through routine nursing.