摘要
目的比较不同血压管理模式对社区血压干预的效果。方法2018年7月至2019年7月通过本项目研发的数据采集管理系统录入杭州市5家社区医疗机构1844例研究对象资料,随机分为观察组和对照组;对照组按照一般社区慢病管理模式管理,观察组在对照组基础上增加医务人员技能培训、健康教育和健康促进等工作。观察12个月后两组血压水平及门诊量的变化情况。结果基线血压分布构成比:高血压819例(44.4%),正常高值血压287例(15.6%),正常血压603例(32.7%),低血压135例(7.3%)。男性舒张压、收缩压、体重、身高、腰围、BMI均明显高于女性(均P<0.01)。随访12个月后发现:观察组、对照组数据基线可比;高血压者:对照组舒张压下降幅度较观察组更高,差异有统计学意义(P<0.01);正常高值血压者:观察组舒张压较对照组下降明显,差异有统计学意义(P<0.01);正常血压者:观察组和对照组均出现血压升高,对照组收缩压升高幅度高于观察组,差异有统计学意义(P<0.01)。观察组1年内5个随访时间点重复测量血压值比较差异均有统计学意义(均P<0.05),随着时间的延长高血压者收缩压下降明显,正常高值血压者收缩压、舒张压均有明显改善,正常血压者血压升高,低血压者舒张压、收缩压水平有明显升高。结论观察组血压改善优于对照组,其血压管理模式可以在社区血压管理工作中应用与推广。
Objective To evaluate the effectiveness of blood pressure management program in the community.Methods From July 2018 to July 2019,1844 residents from 5 communities in Hangzhou were enrolled in the study.The subjects were randomly divided into study group and control group:the control group was managed according to the general community chronic disease management mode,and the study group was managed by trained doctors,the health education and health promotion were enhanced on the basis of the control group.Results There were 819 subjects(44.4%)with hypertension,287(15.6%)with marginal normal blood pressure,603(32.7%)with normal blood pressure and 135(7.3%)with hypotension before intervention.Diastolic blood pressure,systolic blood pressure,body weight,height,waist circumference and body mass index were significantly higher in men than those in women(all P<0.01).One year after intervention,for hypertension subjects the decrease range of diastolic blood pressure in the control group was higher than that in the study group(P<0.01),for subjects with marginal normal blood pressure,the diastolic blood pressure of the study group was significantly lower than that of the control group(P<0.01),for subjects with normal blood pressure,both groups had increased blood pressure,while the range of systolic blood pressure increase in control group was higher than that in study group(P<0.01).In the study group,during the 5 follow-up examinations the systolic blood pressure gradually decreased in hypertensive patients,systolic blood pressure and diastolic blood pressure were significantly improved in subjects with marginal normal blood pressure,blood pressure in normal blood pressure subjects was increased,diastolic blood pressure and systolic blood pressure levels were significantly increased in low blood pressure subjects(all P<0.05).Conclusion The study shows that the improvement of blood pressure in the study group is better than that in the control group,and the blood pressure management program can be applied and popularized in community blood pressure management.
作者
杨奕
寿晓玲
杨丽
YANG Yi;SHOU Xiaoling;YANG Li(Department of Cardiac Rehabilitation,Zhejiang Hospital,Hangzhou 310013,China)
出处
《浙江医学》
CAS
2020年第18期1944-1948,1953,共6页
Zhejiang Medical Journal
基金
浙江省科技计划项目(2016C33123)。
关键词
社区健康服务
健康促进
高血压
低血压
Community health services
Health promotion
Hypertension
Hypotension
