中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
1期
11-13
,共3页
高血压%社区卫生服务
高血壓%社區衛生服務
고혈압%사구위생복무
Hypertension%Community health services
目的 比较社区老年高血压患者不同血压管理方式,探索社区慢性病管理的有效模式.方法 选取北京市丰台区蒲黄渝社区卫生服务中心的302例老年高血压患者,采用随机数字法分为2组,常规管理组(对照组)152例,常规高血压药物结合门诊管理,自测血压组150例,在常规管理组基础上,患者自备电子血压计,每周至少自我测量2 d(晨起、睡前)记录血压和心率值,社区门诊调整治疗方案.干预1年后,比较组间服药依从性、血压控制水平及血压控制达标情况. 结果 经1年综合管理,自测血压组患者服药依从高于对照组[94.7％(142例)与75.7％(115例),P＜0.05].自测血压组的收缩压水平低于对照组,对照组平均收缩压由管理前(168.5±37.7) mmHg(1 mmHg=0.133 kPa)降至为管理后(155.3±25.2) mmHg;而自测血压组由管理前(168.0±38.1) mmHg降低为管理后(141.7±22.9) mmHg,差异有统计学意义(P＜0.05),自测血压组干预前后血压达标率、高于对照组,差异有统计学意义(P＜0.05). 结论 患者自我参与监测血压能更有效控制血压,同时可提高社区老年慢病患者自我管理的能力.
目的 比較社區老年高血壓患者不同血壓管理方式,探索社區慢性病管理的有效模式.方法 選取北京市豐檯區蒲黃渝社區衛生服務中心的302例老年高血壓患者,採用隨機數字法分為2組,常規管理組(對照組)152例,常規高血壓藥物結閤門診管理,自測血壓組150例,在常規管理組基礎上,患者自備電子血壓計,每週至少自我測量2 d(晨起、睡前)記錄血壓和心率值,社區門診調整治療方案.榦預1年後,比較組間服藥依從性、血壓控製水平及血壓控製達標情況. 結果 經1年綜閤管理,自測血壓組患者服藥依從高于對照組[94.7％(142例)與75.7％(115例),P＜0.05].自測血壓組的收縮壓水平低于對照組,對照組平均收縮壓由管理前(168.5±37.7) mmHg(1 mmHg=0.133 kPa)降至為管理後(155.3±25.2) mmHg;而自測血壓組由管理前(168.0±38.1) mmHg降低為管理後(141.7±22.9) mmHg,差異有統計學意義(P＜0.05),自測血壓組榦預前後血壓達標率、高于對照組,差異有統計學意義(P＜0.05). 結論 患者自我參與鑑測血壓能更有效控製血壓,同時可提高社區老年慢病患者自我管理的能力.
목적 비교사구노년고혈압환자불동혈압관리방식,탐색사구만성병관리적유효모식.방법 선취북경시봉태구포황투사구위생복무중심적302례노년고혈압환자,채용수궤수자법분위2조,상규관리조(대조조)152례,상규고혈압약물결합문진관리,자측혈압조150례,재상규관리조기출상,환자자비전자혈압계,매주지소자아측량2 d(신기、수전)기록혈압화심솔치,사구문진조정치료방안.간예1년후,비교조간복약의종성、혈압공제수평급혈압공제체표정황. 결과 경1년종합관리,자측혈압조환자복약의종고우대조조[94.7％(142례)여75.7％(115례),P＜0.05].자측혈압조적수축압수평저우대조조,대조조평균수축압유관리전(168.5±37.7) mmHg(1 mmHg=0.133 kPa)강지위관리후(155.3±25.2) mmHg;이자측혈압조유관리전(168.0±38.1) mmHg강저위관리후(141.7±22.9) mmHg,차이유통계학의의(P＜0.05),자측혈압조간예전후혈압체표솔、고우대조조,차이유통계학의의(P＜0.05). 결론 환자자아삼여감측혈압능경유효공제혈압,동시가제고사구노년만병환자자아관리적능력.
Objective To compare the effects of different methods of blood pressure management in elderly hypertensive patients in the community,so as to explore the effective model for the management of chronic diseases.Methods 302 elderly hypertensive patients in Puhuangyu community health service center were divided into two groups by random number method:(1) receiving conventional antihypertensive drugs (control group,n=152);(2) receiving antihypertensive drugs combined with blood pressure self-measurements at least twice-weekly and real-time adjusting antihypertensive management (blood pressure self-measurements group,n =150).Medication adherence,levels of blood pressure control and blood pressure-targeting rate were compared between groups one year after intervention.Results Medication adherence rate was higher in self-measurements group than in the control group [94.7％ (142 cases) vs.75.7％ (115 cases),P＜ 0.05].After intervention,systolic pressure was decreased from (168.5±37.7) mmHg to (155.3±25.2) mmHg(1 mmHg=0.133 kPa) in the control group and from (168.0±38.1)mmHg to (141.7 ±22.9) mmHg in self-measurements group (all P＜0.05).Diastolic pressure level was similar in the two groups.There was a significant difference in the blood pressure-targeting rate between groups (P ＜0.05).Conclusions Blood pressure self-measurements are more effective in controlling blood pressure and can improve the self-management ability in elderly patients with chronic diseases in the community.
