医院-社区综合管理模式对原发性高血压控制效果影响分析

目的评价医院-社区综合管理模式对患者高血压控制的干预效果,以期为建立高血压有效控制模式提供依据。方法收集2010年1月至于2012年12月在深圳市福田区妇幼保健院就诊治疗的高血压患者473例为观察组,另选同期在医院常规治疗的高血压患者387例为对照组,观察组给予医院社区综合管理模式,建立档案采用综合规范化治疗,定期到社区随访;对照组采用常规的医院门诊治疗,即时健康教育、自行锻炼和饮食控制;比较两组患者干预前后血压控制情况、高血压相关知识知晓率、生活方式等方面的变化。结果经过社区医院综合管理后,观察组收缩压和舒张压均较干预前显著降低,较对照组下降明显(P<0.05)。经过社区医院综合管理后,观察组血压控制率、高血压知识知晓率、服药依从性分别由28.54%、38.48%、50.95%上升至57.93%、92.39%、90.70%,差异有统计学意义(P<0.05),与对照组比较差异也有统计学意义(P<0.05)。经过干预管理后观察组高血压患者的生活方式明显改善,危险行为减少,与对照组比较差异有统计学意义(P<0.05)。结论高血压的社区医院综合管理模式可有效控制患者的血压,提高患者的依从性,改善其生活方式,是综合防治高血压的有效管理模式。

Analysis on the Effect of Hospital and Community Comprehensive Management Mode on Blood Pressure Control in Primary Hypertension Patients

Objective To investigate the effect of hospital and community comprehensive management mode on blood pressure control in primary hypertension patients,and provide foundation for effective mode of the blood pressure controlling.Methods A total of 473 cases of hypertension patients admitted in Maternal and Child Health Care Hospital of Futian District from Jan.2010 to Dec.2012 were randomly divided into observationgroup and control group：patients in the observation group（86 cases） were served under hospital and community comprehensive management mode,with individual record archived in the hospital and regular follow-up in community;while patients in the control group（387 cases） were given regular outpatients seice in hospital,in addition to immediate health education,self-exercise and diet control.The changes of patients＇blood pressure,lifestyles and awareness of hypertension-related knowledge before and after intervention were compared between the two groups.Results After one-year hospital and community comprehensive management,systolic blood pressure and diastolic blood pressure of the observation group decreased more significantly compared with the control group （P 〈 0.05）.Besides,controlled rate of patients＇blood pressure,awareness of hypertension-related knowledge,and the medication compliance rate of the observation group respectively increased from 28.54 %,38.48 %,50.95 % to 57.93 %,92.39 %,90.70 % after comprehensive management,the differences were statistically significant （P 〈 0.05）,and the difference of above rates between the two groups were also statistically significant（P 〈 0.05）.After intervention,lifestyle of patients in the observation group greatly improved,with less unfavorable behaviors,such differences between the two groups were statistically significant（P 〈 0.05）.Conclusion H ospital and community comprehensive management mode can effectively control the blood pressure of hypertension patients,and improve their compliance so as to enhance the quality of l