社区人群高血压防治的护理干预

目的通过社区护理干预,提高人群的高血压知晓率、治疗率和控制率.方法在社区13 066人随机选择高血压病人550人,筛查出高危人群352人.对高血压病人以及高危人群进行了2年的社区护理干预,高血压服药组病人遵医性和高危人群的饮食、行为进行干预和健康教育.结果社区高血压及高危人群服药遵医性、危险因素及血压行为改变干预前后有显著性差异(P＜0.01).说明护理干预后高血压组病人服药率和高危人群的血压控制及不良饮食行为比干预前改变很大.结论社区护理干预是控制和防治高血压的有效方法.     

护理干预对冠心病高危因素影响的探讨

目的 通过分析冠心痛的三大高危因素(高血压、高血脂、糖尿病)，探讨护理干预与冠心病高危因素的关系。方法 对干预组人群进行为期2年的护理干预和追踪随访，并与对照组进行比较。结果 干预组对冠心病三大高危因素控制效果明显，与对照组比较差异有显著性。结论 通过有效的护理干预，对降低冠心病的发生率有积极的作用。     

妊娠高血压综合征的早期干预

妊娠高血压综合征是妊娠特有的疾病,是临床上常见的严重危害母婴健康的妊娠合并症.本文对妊娠高血压综合征的高危因素、监测方法、护理干预及治疗作了全面的阐述.     

短暂性脑缺血发作的高危因素分析及护理干预

总结92例短暂性脑缺血发作的高危因素及护理干预。肥胖、吸烟、不良饮食习惯、高血压、高脂血症、糖尿病、心脏病、颈椎病等为短暂性脑缺血发作的高危因素。对短暂性脑缺血发作患者的高危因素进行目标控制,可以减少复发,并减少继发脑卒中的危险性,降低病残率,延长生存期。     

神经外科围术期并发症高危因素分析及临床护理

目的:分析神经外科围术期并发症高危因素,探讨临床护理干预策略。方法:回顾性分析2015年1~5月成功实施神经外科手术的628例患者资料,其中48例发生术后并发症,运用Logistic分析神经外科围术期并发症高危因素,同时探讨临床护理干预效果。结果:628例患者中发生术后并发症48例,经过单因素条件Logistic分析高危因素为糖尿病、既往行经皮冠状动脉介入、反复穿刺、留置鞘管;多因素Logistic分析高血压、静脉内应用刺激性强药物及静脉内留置管道是诱发术后并发症的独立危险因素。通过护理干预处理,患者症状得到有效控制。结论:神经外科围术期并发症的形成受多因素作用,对高危患者应当密切观察病情,给予规范化治疗及护理干预十分必要。     

社区高血压患者的三级预防及干预

目的 探讨早期发现高血压实施有效的三级预防及干预,降低患病率和死亡率的方法.方法 通过健康体检查出患病因素,发现高危人群和患病者,做好"三级干预",并实施切实可行的社区干预措施.结果 共体检1 745人,高血压患病237例(14.5%);接受体检的男性高血压患者患病率明显高于女性,高年龄组患病率高于低龄组,高血压患病组各项临床指标与正常组比较有显著差异.说明年龄,肥胖,吸烟,食盐量是高血压患者的影响因素.结论 近年高血压的患病率总体呈上升趋势,应加强对社区居民生活习惯的监控与干预,降低患病率,提高社区居民健康水平.     

合约式干预对35岁以上育龄妇女高血压高危人群血压的有效性观察

目的观察合约式干预对35岁以上育龄妇女高血压高危人群血压的有效性。方法按照《高血压防治指南》要求,运用《高危人群筛查表》筛查选取200例35岁以上育龄妇女高血压高危人群,按照数字随机分组法分观察组(使用合约式干预方法组)与对照组(未使用合约式干预方法组)各100例,分别观察两组妇女的生活习惯改善情况与血压情况。结果观察组妇女在生活干预效果(有效率98.00%)显著优于对照组,高血压发生率(3%)显著低于对照组,差异有统计学意义(P0.05)。结论合约式干预方法能够改善35岁以上育龄妇女中高血压高危人群的生活方法并帮助其实现血压控制,达到减少高血压病发生的目的,改善高危人群妊娠结局。     

循证护理实践推荐

临床问题生活方式干预对心血管疾病高危人群以及心血管疾病患者一级和二级预防的最佳证据是什么?临床描述心血管疾病(Cardiovascular disease,CVD)有许多危险因素,如缺乏运动、吸烟、肥胖,高胆固醇和高血压和糖尿病等。心血管疾病患者更易发生心血管事件,如心肌梗死、脑卒中和因心血管疾病导致的死亡。减少危险因素在心血管疾病一级和二级预防中尤为关键。生活方式干预可减少一些心血管的高危因素,因而备受关注。     

循证护理在社区高血压三级预防中的应用

目的运用循证护理fEBN）方式，遵循科学的原则和依据，使社区高血压患者及高血压高危个体运用正确的保健知识，建立健康的生活方式，提高生存质量。方法深入社区，采用问卷调查方式，筛检出高血压高危个体及经医疗机构确认的高血压患者176例，评估患者的需求，了解其家族史，饮食习惯及不适症状，针对存在的问题，查询求证相关的资料，制定预防措施，有针对性地进行健康行为干预，改变行为危险因素；达到高血压三级预防的最佳效果。结果健康行为干预后患者能自觉改变不良饮食习惯及行为危险因素．超重人员明显减少，依从性较干预前明显提高，均p〈0．01，差异有统计学意义。结论开展循证护理有助于增强患者的意识及能力，达到最佳的预防效果。     

上海市某院脑卒中筛查危险因素与危险程度分析

目的 初步了解上海市某院脑卒中筛查情况,并对危险因素与危险程度分析,为医院建立脑卒中的预防干预体系提供科学依据。 方法 对来我院自愿要求筛查,符合筛查条件的个体共2488人,进行调查评估,区分出高,中,低危人群,并进行危险因素与危险程度的分析。 结果 筛查人群中高危人群占51.5%,高危人群中危险因素以年龄比例影响最多占83.9%。其次为高血压、心血管疾病,分别占79.7%、46.8%。糖尿病占32.3%,吸烟占24.4%,房颤占12.8%,左心室肥厚占10.7%。其中高血压与非高血压者的危险程度差异有统计学意义(P〈0.01〉,糖尿病与非糖尿病者的危险程度差异有统计学意义(P〈0.01〉,吸烟与不吸烟者的危险程度差异有统计学意义(P〈0.01〉,心血管疾病与非心血管疾病者的危险程度差异有统计学意义(P<0.01).结论 上海市某院脑卒中筛查以高危人群居多,高危人群的危险因素以年龄,高血压,心血管疾病所占比例较高,应作为脑卒中干预防治的重点。且高血压,糖尿病,心血管疾病以及吸烟者与血压正常,非糖尿病,心血管疾病以及不吸烟者的危险程度差异均有统计学意义。因此,对于上述的危险因素医护人员应早期、及时、积极的强化干预即控制血压,血糖,治疗心脏病,生活方式干预等,以降低脑卒中的发病风险。     

三级危险分群管理在社区老年高血压防控中的应用

目的将三级危险分群管理应用于高血压疾病的社区管理,以探讨危险分群管理对高血压的防控作用。方法将社区老年人分为全人群、高危人群和高血压患者三级人群,对不同人群实施相应的高血压防控措施,分别在项目实施前(2003年)、中(2006年)、后期(2010年)进行调查。结果自2003年至2010年,社区老年人的高血压患病率从53.0%增高至68.8%,各阶段差异均有统计学意义(P<0.01);实施三级危险分群管理中期和后期,社区老年人的高血压知晓率和治疗率均高于管理前期(P<0.01);管理中期高血压控制率高于管理前期(P<0.05),但管理后期高血压控制率反而略有下降。结论面对老年人群高血压流行的现状,高血压防控工作仍需进一步加强;而三级危险分群管理能将家庭、社区和医院有机结合在一起,提高高血压防控工作的效果。     

高血压病患者防治依从性的调查分析

目的了解高血压病患者的各种不合理的生活方式，并进行服务性的全方位干预。方法采用自行设计的高血压病预防保健知识应用状况的调查问卷，对324例高血压病患者的症状、危害性、治疗与预防保健知识应用状况进行调查，并进行干预。结果自觉应用高血压病的预防保健知识来改变生活方式的患者所占比例很低。结论针对高血压病预防保健知识应用状况的薄弱环节，有目的地改变生活方式．做到知行合一，从而提高高血压病患者的防治积极性，以增强疗效，提高生活质量，预防疾病的发展。     

Issues and trends in care of the hypertensive client

This article discusses issues and trends in care of the hypertensive client that pertain to practice, education, research, and health policy. Clinical practice issues center around obtaining accurate blood pressure measurements and educating patients about health promotion interventions and use of medications. These topics are important in the education of the beginning nurse student as well. Researchers have studied risk factors, incidence, and prevalence in global populations; use of pharmacologic agents; and investigative methods employing technology. Researchers are beginning to explore more holistic approaches to controlling risk factors before hypertension occurs. Funding for public education regarding prevention and control of hypertension is a number one health policy issue.     

Interventions to prevent and manage overweight or obesity in preschool children: A systematic review

ObjectivesThe preschool period is a pivotal time for lifestyle interventions to begin the establishment of long-term physical activity and healthy eating habits. This systematic review sought to (a) examine the effects of prevention and management interventions on overweight/obesity among children aged 2–5 years, and (b) explore factors that may influence intervention effects.DesignA systematic review of randomized controlled studies was conducted.Data sourcesSix databases, including PubMed, CINAHL, EMBASE, PsycINFO, ERIC, and Cochrane library, were searched for relevant studies.Review methodsData were extracted and checked by two reviewers. Each study was appraised based on 4 quality indicators adapted from the Cochrane Handbook for Systematic Reviews of Interventions. A narrative summary technique was used to describe the review findings.ResultsThirty-seven articles describing 32 randomized controlled trials and 29 unique interventions were retained. Eight of 23 prevention and 4 of 6 management interventions resulted in significant weight loss, with 3 prevention and 5 management interventions showing sustained effects over 6 to 24 months. Of the 12 efficacious interventions, 10 included physical activity and nutrition components, 9 actively involved parents, and only 4 were theory-based. Interactive education was the most common strategy used for parents in prevention interventions, compared to behavioral therapy techniques in management interventions. For children, interactive education and hands-on experiences involving physical activity and healthy eating were equally used.ConclusionsManagement interventions showed greater effects in weight loss compared to prevention interventions. Future prevention interventions in preschool children should target both parents and children, and focus on physical activity and nutrition through interactive education and hands-on experiences, although intervention effects were less than optimal. Management interventions should focus on parents as the “agents of change” for physical activity and nutrition while integrating behavioral therapy techniques and interactive education.     

High blood pressure in children and adolescents

High blood pressure in children and adolescents is a growing health problem that is often overlooked by physicians. Normal blood pressure values for children and adolescents are based on age, sex, and height, and are available in standardized tables. Prehypertension is defined as a blood pressure in at least the 90th percentile, but less than the 95th percentile, for age, sex, and height, or a measurement of 120/80 mm Hg or greater. Hypertension is defined as blood pressure in the 95th percentile or greater. A secondary etiology of hypertension is much more likely in children than in adults, with renal parenchymal disease and renovascular disease being the most common. Overweight and obesity are strongly correlated with primary hypertension in children. A history and physical examination are needed for all children with newly diagnosed hypertension to help rule out underlying medical disorders. Children with hypertension should also be screened for other risk factors for cardiovascular disease, including diabetes mellitus and hyperlipidemia, and should be evaluated for target organ damage with a retinal examination and echocardiography. Hypertension in children is treated with lifestyle changes, including weight loss for those who are overweight or obese; a healthy, low-sodium diet; regular physical activity; and avoidance of tobacco and alcohol. Children with symptomatic hypertension, secondary hypertension, target organ damage, diabetes, or persistent hypertension despite nonpharmacologic measures should be treated with antihypertensive medications. Thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are safe, effective, and well tolerated in children.     

Primary prevention of skin cancer in children and adolescents: a review of the literature.

Although skin cancer is an easily preventable disease, self-directed prevention behaviors in children are difficult to achieve. The purpose of this article is to evaluate the status of primary prevention interventions and identify gaps in national and international research in order to make suggestions for further intervention design. A comprehensive search of MEDLINE, CINAHL, and PSYCHinfo databases was conducted to collect published research used in this review. The most effective interventions used multicomponent curricula administered over an extended period of time. Younger children were more receptive to interventions than were older children, who had stronger attitudes against sun-protective behaviors. Interventions in Australia have been more successful than interventions in North America and Europe. Further research needs to be conducted to create primary prevention interventions that address informational gaps. Specifically testing the dose and effect of individual educational components and bundling of components with reliable and valid outcome measures would help health care researchers define and measure the most effective way to battle social norms and attitudes of children and sun exposure.     

老年和青年急性心肌梗死患者诱因的分析及预防

目的 对比分析老年和青年急性心肌梗死患者的诱因，并提出预防对策。方法 选取老年（60岁以上）急性心肌梗死（acute myocardial infarction，AMI）组148例，青年（40岁以下）AMI组64例，对两组的发病诱因进行比较分析。结果老年组无明确AMI诱因者占51．4％，明显高于青年组（P〈0.01），且老年组明确的AMI诱因广泛。老年组和青年组AMI危险因素的侧重点不同（P〈0．05），老年组危险因素合并症多且相互影响，以高血压为首；青年组危险因素以严重的不良生活习惯为主，吸烟最为常见。结论 老年和青年急性心肌梗死患者的诱发因素、危险因素特点不同。据此可制定不同的预防措施。     

Prevention of coronary heart disease. Part II. Secondary prevention, detection of subclinical disease, and emerging risk factors

The prevention of CHD should be a major priority among primary care physicians and subspecialists who have any dealing with the cardiovascular system. There is ample evidence from epidemiologic studies for the impact of specific risk factors on CHD events. There is also ample evidence from observational studies and clinical trials that interventions of lifestyle and pharmacologic therapy can decrease morbidity and mortality from CHD before or after the first event. It behooves the physician who wishes to practice good medicine to understand the pathophysiologic roles of the risk factors and the evidence from epidemiologic studies and clinical trials for their association with cardiovascular disease. It is important to determine the efficacy of interventions, both lifestyle and pharmacologic, in modifying CHD risk. To be effective in doing so, the practicing physician has to have the motivation to determine target goals for risk factor modification in each patient, to understand the patient's own motivations in modifying risk factors, and to define clearly with the patient the expectations of such interventions. Although there are guidelines for risk factor modification in modification of cholesterol and in hypertension, the periodic renewal of these guidelines reflects the changing concepts of risk and its modification. A cardiovascular risk factor intervention categorization is presented in Table 12. The physician must be convinced that such intervention is beneficial to the patient, cost-effective, and thus fulfills the expectations of medical practice. The practice of medicine in the evaluation and treatment of coronary heart disease has always been challenging and stimulating. The prevention of CAD disease should ultimately provide the greatest accomplishment.     

Prevention of childhood injuries. Part II: Recreational injuries.

This is the second of two articles on the prevention of childhood injuries. Here, interventions to reduce death and disability among children from recreational injuries are identified. The major categories of recreational injury are listed, the magnitude of the problem defined, the risk factors described, and selected interventions of the National Committee for Injury Prevention and Control summarized. Recommendations for practice are discussed.     

孤独症儿童围生期危险因素对照分析

目的 探讨孤独症儿童围生期的危险因素.方法 选择孤独症儿童140例,82例健康儿童,用自编一般情况问卷及围生期危险因素调查表进行回顾性调查,问卷由儿童母亲和主要抚养人填写.结果 孤独症儿童的母亲孕期发生病毒性感冒(x2=15.29)以及新生儿缺氧窒息(x2=6.04)、早产(x2=6.48)、难产(x2=2.83)和出生后人工喂养(x2=6.02)均为孤独症儿童的危险因素(P均<0.05).结论 孤独症发病与围生期危险因素有关,早期干预、早期发现及治疗可改善预后.

Abstract：

Objective To compare the risk factor of chilldren with autism and ordinary children during perinatal period. Methods One hundred and fourty children with autism and 82 ordinary children were reviewed by self-written general circumstance questionnaire and risk factor questionnaire. Results Viral influenza during pregnancy (x2 =15.29) ,bom suffocate( x2 =6. 04) , premature delivery (x2 =6. 48) , dystocia (x2 =2. 83) and artificial feeding ( x2 = 6. 02 ) were risk factors for children autism (P < 0. 05 ). Conclusion Childeren autism is associated with risk factors in rinatal period. Early dectecion and early prevention and treatment may improve the outcome.