摘要
目的分析社区规范化管理对高血压患者血压和高血压并发症的影响。方法选取2000年1月—2012年12月就诊于北京市西城区月坛社区卫生服务中心及其各卫生服务站接受高血压社区规范化管理的患者300例作为试验组,同时选取同期就诊于北京市中关村医院心内科门诊并行常规管理的高血压患者300例作为对照组。比较两组患者管理前、管理后5年、管理后10年高血压的变化及高血压分级的变化;比较两组患者管理后5年、管理后10年血压控制率及高血压并发症发生率。结果两组患者的性别构成、年龄、高血压病史、收缩压、舒张压、腰围、体质指数、左心室射血分数、血尿素氮、血肌酐、高血压分级、个人史、用药史(除β受体阻滞剂外)比较,差异均无统计学意义(P>0.05)。两组收缩压和舒张压在管理前、管理后5年、管理后10年比较,差异均无统计学意义(P>0.05)。试验组管理后10年1级高血压发生率高于对照组(P<0.05);试验组管理后5年和管理后10年2级高血压发生率和3级高血压发生率均低于对照组(P<0.05)。试验组管理后5年和管理后10年的血压控制率高于对照组(P<0.05)。试验组管理后5年和管理后10年的脑卒中、冠心病、眼底病变及肾功能不全发生率均低于对照组(P<0.05)。结论社区规范化管理可有效控制高血压患者的血压,并降低、延缓高血压并发症的发生,为社区高血压管理提供了参考依据。
Objective To analyze the impacts of community- based standardization management for patients with hypertension on blood pressure and complications. Methods 300 patients with hypertension receiving community- based standardization management from January,2000 to December,2012 were selected from Beijing Yuetan community health service centers and stations as test group. Another 300 hypertension patients in outpatient and receiving routine management were selected from Beijing zhongguancun hospital as contrast group. Their blood pressure change and hypertension grading change were compared before,5 years and 10 years after management and the control rate and incidence of compliance were also compared 5 years and 10 years after management. Results The differences of gender,age,hypertension history,systolic pressure,diastolic pressure,waist circumference,body mass,Left ventricular ejection fraction,Blood urea nitrogen,serum creatinine,hypertension grading,individual history,medication usage（ exceptβ- blocker） were not significant（ P 0. 05）. The differences of systolic pressure and diastolic pressure before,5 years and 10 years after management were not significant（ P 0. 05）. After 10 years＇ management,the incidence of grade 1 in test group was higher than that in control group（ P 0. 05） and the incidences of grade2 and grade 3 were all lower in test group than in control group 5 years and 10 years after management（ P 0. 05）. The rate of blood pressure in test group was higher than that in control group 5 years and 10 years after management（ P 0. 05）. The incidences of stroke,coronary heart disease,ocular fundus diseases and renal insufficiency were all lower in test group than in control group（ P 0. 05）. Conclusion Community- based standardization management for patients with hypertension can not only control the blood pressure,but also reduce and delay the development of complications of hypertension in patients. It provides reference for community hypertension management.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第29期3421-3424,共4页
Chinese General Practice
关键词
高血压
社区卫生服务
规范化管理
并发症
Hypertension
Community health services
Standardized management
Complications
