中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2011年
1期
13-16
,共4页
陈静静%侯春玲%赵挪安%彭晓霞
陳靜靜%侯春玲%趙挪安%彭曉霞
진정정%후춘령%조나안%팽효하
高血压%疾病管理%乡村卫生服务
高血壓%疾病管理%鄉村衛生服務
고혈압%질병관리%향촌위생복무
Hypertension%Disease management%Rural health services
目的 了解农村社区抗高血压药物的使用情况,为如何提高基层社区高血压患者管理质量提供重要信息.方法 于2008年6月至2009年5月间,通过调查健康档案中全科诊疗记录、慢病管理记录及患者问卷调查,对北京市怀柔区桥梓镇社区高血压患者抗高血压药物的使用情况、血压控制情况及其影响因素进行分析.结果 849例农村社区管理的高血压患者中,78.92%(670/849)的患者服药,其中72.54%(486/670)规律服药.486例规律服药患者中,144例(29.63%)患者在社区医生指导或二级以上医院就诊;302例(62.14%)患者自行服药;40例(8.23%)经亲属或其他患者介绍服药.503例能给出药名的服药患者中使用最多的药物为复方利血平或复方利血平氨苯喋啶(302例,60.04%);其次为钙拮抗剂(181例,35.98%).此外,该社区管理高血压患者的血压总控制率为34.04%(289/849);规律服药组的血压控制率为38.89%(189/486),高于不服药组患者(26.82%)(48/179),差异有统计学意义(P=0.0032).多元logistic回归分析结果提示,对患者是否用药影响最明显的是患者有无并发症(OR=4.423,95% CI=2.141～9.137).结论 北京农村社区高血压患者的规律服药率仍较低,服用降压药以复方降压药占大部分;社区医生在健康教育中应重视宣教高血压患者何时开始服用降压药,如何科学服用.
目的 瞭解農村社區抗高血壓藥物的使用情況,為如何提高基層社區高血壓患者管理質量提供重要信息.方法 于2008年6月至2009年5月間,通過調查健康檔案中全科診療記錄、慢病管理記錄及患者問捲調查,對北京市懷柔區橋梓鎮社區高血壓患者抗高血壓藥物的使用情況、血壓控製情況及其影響因素進行分析.結果 849例農村社區管理的高血壓患者中,78.92%(670/849)的患者服藥,其中72.54%(486/670)規律服藥.486例規律服藥患者中,144例(29.63%)患者在社區醫生指導或二級以上醫院就診;302例(62.14%)患者自行服藥;40例(8.23%)經親屬或其他患者介紹服藥.503例能給齣藥名的服藥患者中使用最多的藥物為複方利血平或複方利血平氨苯喋啶(302例,60.04%);其次為鈣拮抗劑(181例,35.98%).此外,該社區管理高血壓患者的血壓總控製率為34.04%(289/849);規律服藥組的血壓控製率為38.89%(189/486),高于不服藥組患者(26.82%)(48/179),差異有統計學意義(P=0.0032).多元logistic迴歸分析結果提示,對患者是否用藥影響最明顯的是患者有無併髮癥(OR=4.423,95% CI=2.141～9.137).結論 北京農村社區高血壓患者的規律服藥率仍較低,服用降壓藥以複方降壓藥佔大部分;社區醫生在健康教育中應重視宣教高血壓患者何時開始服用降壓藥,如何科學服用.
목적 료해농촌사구항고혈압약물적사용정황,위여하제고기층사구고혈압환자관리질량제공중요신식.방법 우2008년6월지2009년5월간,통과조사건강당안중전과진료기록、만병관리기록급환자문권조사,대북경시부유구교재진사구고혈압환자항고혈압약물적사용정황、혈압공제정황급기영향인소진행분석.결과 849례농촌사구관리적고혈압환자중,78.92%(670/849)적환자복약,기중72.54%(486/670)규률복약.486례규률복약환자중,144례(29.63%)환자재사구의생지도혹이급이상의원취진;302례(62.14%)환자자행복약;40례(8.23%)경친속혹기타환자개소복약.503례능급출약명적복약환자중사용최다적약물위복방리혈평혹복방리혈평안분첩정(302례,60.04%);기차위개길항제(181례,35.98%).차외,해사구관리고혈압환자적혈압총공제솔위34.04%(289/849);규률복약조적혈압공제솔위38.89%(189/486),고우불복약조환자(26.82%)(48/179),차이유통계학의의(P=0.0032).다원logistic회귀분석결과제시,대환자시부용약영향최명현적시환자유무병발증(OR=4.423,95% CI=2.141～9.137).결론 북경농촌사구고혈압환자적규률복약솔잉교저,복용강압약이복방강압약점대부분;사구의생재건강교육중응중시선교고혈압환자하시개시복용강압약,여하과학복용.
Objective To understand use of blood pressure-lowering medications and to identify factors contributing to their compliance among hypertensive patients at a community health-care service center under Huairou County Hospital, Beijing to improve community management for hypertensive therapy.Methods Medical records of hypertensive patients who visited Qiaozizhen community health-care service center in Huairou county, Beijing during June 2008 to May 2009 were analyzed and 849 of them were interviewed using a pre-tested, structured questionnaire with most closed ended questions included to understand their use of anti-hypertensive drugs and its related factors. Results In 849 hypertensive patients under community management, 78.92% percent (670/849) took anti-hypertensive drugs, 72.54%percent (486/670) in good compliance with drug treatment, and 29. 63 percent (144/486) under guidance of their general practitioners or visited secondary-care hospitals or above, 62. 14 percent (302/486) took drugs by themselves and 8. 23 percent (40/486) took drugs following advice by their relatives or other hypertensive patients. The most common used drugs in 503 hypertensive patients who could remember names of the drugs included reserpine compound tablets, reserpine and triamterene compound tablets (302/503, 60. 04% ) and calcium-channel blockers ( 181/503,35.98% ). Overall, blood pressure was under control in ( 289/849,34. 04% ) percent of those with community management, and( 189/486, 38. 89% ) percent of them kept in a good compliance, significantly higher than that in those with poor compliance (48/179,26. 82% ) (P =0. 0032). Results of multivariate logistic regression analysis showed that drug compliance associated mainly with complications of hypertension ( OR of 4. 423 and 95% CI of ORs 2. 141 - 9. 137). Conclusions Drug compliance among hypertensive patients is still poor in rural Beijing, most with reserpine compound tablets.It is necessary to pay more attention to health education among hypertensive patients, particularly about when to start drug-taking and how to take drugs in a scientific way-regularly and complying with physicians'prescription.
