CAJ | 학술논문

目的：评价以“规模化、规范化、信息化”为核心的高血压社区控制技术对高血压人群的管理效果。方法2010年以《中国高血压防治指南》为依据，建立以“规模化、规范化、信息化”为核心的高血压社区控制技术，选择浙江省有代表性的城市、城镇、农村社区高血压人群为研究对象进行大规模社区干预试验。按照高血压社区控制技术制订实施方案，规范化培训干预组医生，按照方案要求对干预组高血压患者进行分级管理。结果截至2013年12月共管理了高血压患者20807例。其中干预组从基线的8996例增加到12295例，规范管理率达到86.8%；干预组高血压患者平均收缩压和平均舒张压分别下降了11.21 mmHg和8.55 mmHg (均为P﹤0.05)，治疗率和控制率由基线时的55.4%和38.6%提高到86.7%和77.8%(均为P﹤0.05)，心血管危险因素有显著改善(均为P﹤0.05)，急性心血管事件发生呈下降趋势。结论高血压社区控制技术能有效提高社区高血压规范管理率，有效改善社区高血压人群防治效果。
목적：평개이“규모화、규범화、신식화”위핵심적고혈압사구공제기술대고혈압인군적관리효과。방법2010년이《중국고혈압방치지남》위의거，건립이“규모화、규범화、신식화”위핵심적고혈압사구공제기술，선택절강성유대표성적성시、성진、농촌사구고혈압인군위연구대상진행대규모사구간예시험。안조고혈압사구공제기술제정실시방안，규범화배훈간예조의생，안조방안요구대간예조고혈압환자진행분급관리。결과절지2013년12월공관리료고혈압환자20807례。기중간예조종기선적8996례증가도12295례，규범관리솔체도86.8%；간예조고혈압환자평균수축압화평균서장압분별하강료11.21 mmHg화8.55 mmHg (균위P﹤0.05)，치료솔화공제솔유기선시적55.4%화38.6%제고도86.7%화77.8%(균위P﹤0.05)，심혈관위험인소유현저개선(균위P﹤0.05)，급성심혈관사건발생정하강추세。결론고혈압사구공제기술능유효제고사구고혈압규범관리솔，유효개선사구고혈압인군방치효과。
Objective To evaluate the effects of hypertension community control technique, which centered on ‘scalization, standardization, informatization ' , on community hypertension management in Zhejiang Province. Methods We established the hypertension community control technique based on 2005 Chinese guidelines for the management of hypertension, and conducted a large-scale community-based intervention trial. The selected communities were representative communities from city, town and countryside in Zhejiang province. An implement scheme was developed according to the hypertension community control technique. Grass-roots doctors in intervention group were trained standardly and required to manage hypertentives based on the implement scheme. Hypertension community standardized management rate, hypertensives' blood pressure, cardiovascular risk factors, awareness rate, treatment rate, control rate, and incidence of acute cardiovascular events were investigated. Results Till December 2013, 20 807 hypertensives were enrolled in the management, and the number was increased from 8 996 to 12 295 in intervention group. Among hypertensives in intervention group, the standardized management rate was 86. 8%, as well as the average systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) declined 11. 21 mmHg and 8. 55 mmHg, respectively ( both P﹤0. 05). The treatment rate improved from 55. 4% to 86. 7% (P﹤0. 05), and the management rate from 38. 6% to 77. 8% in the intervention group. Also, the intervention was effective in significantly ameliorated cardiovascular risk factors while the incidence rate of acute cardiovascular events had decreased. Conclusions Hypertension community control technique can improve standardized management rate, and effectively prevent and control hypertension at community level.