| 农村社区高血压管理效果对比研究 |
| 投稿时间：2014-10-13 修订日期：2014-10-24 点此下载全文 |
| 引用本文：王增武,隋辉,王馨,范国辉,陈祚,张林峰,刘孝玉,周永鑫,张玉琛,冯志荣,谯小伟,万力萍.农村社区高血压管理效果对比研究[J].医学研究杂志,2015,44(1):25-28 |
| DOI：
10.3969/j.issn.1673-548X.2015.01.008 |
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| 基金项目:"十二五"国家科技支撑计划项目(2012BAJ18B04) |
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| 中文摘要:目的 通过对比研究评价在农村社区开展高血压管理的效果。方法 采取流行病学类实验的方法,在甘肃榆中县抽取2个乡社区卫生服务中心为干预组;在永登县选择经济水平、医疗条件相当的两个乡社区卫生服务中心作为常规组。干预组医务人员用简易农村社区高血压管理流程培训,并按照流程要求管理患者,每个患者管理半年;常规组沿用现行处理原则,收集基线及6个月时的资料。主要指标为血压控制率。效果为基线的率(均值)－半年后的率(均值)。结果 干预组患者半年后的收缩压、舒张压分别下降了12.0mmHg(P<0.05)、6.9mmHg(P<0.05),缺乏运动的比例也降低12.8%(P<0.05),血压控制率增加了65.2%(P<0.05)。常规组仅血糖降低了2.0mmol/L(P<0.05),总胆固醇增加了0.5mmol/L(P<0.05)。干预组患者吸烟、缺乏运动的比例随随访时间延长逐渐下降,血压水平也呈类似趋势,而BMI无显著变化;血压控制率随管理时间延长控制率而逐步升高。结论 在农村社区高血压患者中进行管理可以显著改善高血压控制状况。 |
| 中文关键词:高血压 社区卫生服务 疾病管理 效果评价 农村 |
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| Comparative Research on Hypertension Management in Rural Communities in China |
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| Abstract:Objective To determine the effect of hypertension management in rural community using comparative study. Methods With epidemiological quasi-experiment method, two township-level community health centers were randomly selected as intervention group (IP) in Yuzhong county, Gansu province; so two comparable township-level community health centers were done as routine group (RP) in Yongdeng, Gansu province. The grass-roots doctors from IP were trained using the clinical route of hypertension management for rural community developed based on the current Chinese guideline, and required to manage hypertensive patients according to the route. Patients were followed up regularly, treated with therapy life style change or/and medication. The control rate of hypertension was evaluated after six months. Effect of intervention (EI) was estimated as rate (mean) in baseline minus it in six month. Results In IP, the EI of systolic/diastolic blood pressure was 12.0/6.9mmHg (P<0.05). The EI of inactivity was 12.8% (P<0.05), and the control rate had an increase of 65.2% (P<0.05). However, EI of fasting glucose, total cholesterol was 2.0mmol/L (P<0.05) and -0.5mmol/L (P<0.05), respectively, in RP. For all patients in IP, the longer the management was, the lower the rate of smoking, inactivity and control of hypertension, as well as the level of blood pressure. There was no significant change for body mass index. Conclusion Our study showed that hypertension management could significantly improve the control of hypertension in rural communities in China. |
| keywords:Hypertension Community health services Disease management Effect Rural |
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