护士主导下的慢性病管理模式对高血压患者血压管控的影响效果研究

Research on the effect of a nurse-led chronic disease management model on blood pressure control in hypertensive patients

目的分析以护士为主导的新型慢性病管理模式与常规处理模式相比,对原发性高血压患者血压管控和生理指标等观测指标的影响。方法选取2016-03-01-2018-12-31西安交通大学第二附属医院心血管内科住院治疗的原发性高血压患者300例,采用随机数表法根据患者的就诊顺序将入组的高血压患者分为新模式组(162例)和常规处理组(138例)。新模式组采用护士主导的新型慢性病管理模式,常规处理组采用常规随访服务。应用高血压患者生命质量测定表(QLICD-HY)等进行研究。收集患者血尿样本,采用独立样本t检验或χ^(2)检验比较患者治疗前后血压、生理指标等改变。结果新模式组采用新模式治疗后患者收缩压为(142.60±13.50)mmHg,其改善情况优于常规处理组处理后的(146.30±15.71)mmHg,差异有统计学意义(t=4.794,P<0.05),生理指标方面,新模式治疗后患者低密度脂蛋白为(2.60±0.52)mmol/L,显著优于常规处理组处理后的(3.00±1.26)mmol/L,差异有统计学意义,t=107.711,P<0.001。结论高血压患者实施以护士为主导的新型慢性病管理模式可显著降低血压,提高生活质量,降低低密度脂蛋白,值得进一步推广应用。

Objective To analyze the impact of a nurse-led new chronic disease management model compared to conventional treatment models on blood pressure control and physiological indicators in patients with essential hypertension.Methods A total of 300 patients with essential hypertension who were hospitalized in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Xi'an Jiaotong University between March 1,2016,to December 31,2018 were divided into a new model group(162 cases)and a conventional treatment group(138 cases)according to the order of patients'visits using the random number table method.The new model group used the new nurse-led chronic disease management model,and the conventional treatment group used the conventional follow-up service.The Quality of Life Inventory for Hypertensive Patients(QLICD-HY)was used to measure the quality of life of hypertensive patients.Blood and urine samples were collected from patients.Independent sample t test or Chi-square test were used to compare the changes of blood pressure and physiological indicators before and after treatment.Results The systolic blood pressure of patients in the new model group was(142.60±13.50)mmHg after intervention with the new mode,which was better than that in the conventional treatment group(146.30±15.71)mmHg,the difference was statistically significant(t=4.794,P=0.029).The low density lipoprotein of the patients from the new model group after the new mode intervention was(2.6.0±0.52)mmol/L,which was significantly better than the(3.00±1.26)mmol/L in the conventional treatment group,and the difference was statistically significant(t=107.711,P<0.001).Conclusion The implementation of the new nurse-led chronic disease management model can significantly reduce blood pressure,improve quality of life,and lower low-density lipoprotein for hypertensive patients,and thus it is worth further promotion and application.