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1.
目的:探索以社区卫生服务机构全科医师为主体的团队对高血压患者干预的管理模式、管理效果及其存在问题,探讨促进高血压患者健康的有效措施,为社区高血压综合干预对策提供依据。方法:整群抽取东莞市石排镇社区卫生服务中心辖区内的968名(资料完整者965名)高血压患者为研究对象,通过全科医师团队对其进行为期1年的综合干预,比较管理前后高血压患者的知晓率、服药率和血压控制率。结果:管理后高血压患者的知晓率、服药率、控制率分别从管理前的61.5%、69.7%、41.2%提高到98%、92.6%、82.3%,差异均有统计学意义( P <0.01)。结论:以社区卫生服务中心全科医师团队为主体的社区综合干预措施,可以提高高血压患者的知晓率和依从性、改变不良生活方式,控制患者的血压,降低其死亡率、并发症发生率,提高生活质量,值得推广。  相似文献   

2.
兰州市七里河区龚家湾街道第一社区卫生服务中心在社区内进行高血压健康促进工作,运用现代策略完成对电机厂社区高血压患者、健康人群、高危人群的健康促进工作,取得显著的社会效益和经济效益,社区人群高血压预防知晓率普遍提高,参与意识增强。通过高血压健康促进工作,社区卫生服务中心健康教育机构建设得到加强,人员素质不断提高,实验室检查、诊断、高血压归口管理及病例登记、监测等整体服务得到提高,为高血压防治工作的可持续发展及下一步慢病控制的实施打下坚实的基础。  相似文献   

3.
发展社区卫生服务是合理利用卫生资源,满足人民群众日益增长的卫生服务需求,提高人民健康水平的重要保证,社区护理是社区卫生服务的重要组成部分。社区护理是将公共卫生学及护理学理论相结合,用以促进和维护社区人群健康的一门综合学科,是以健康为中心,以社区人群为对象,以促进和维护社区人群健康为目标,这就要求社区卫生服务机构,走进社区,进入家庭,为居民建立家庭健康档案,提供常见病的诊治和家庭出诊,家庭病床等服务。  相似文献   

4.
目的了解城市社区60岁及以上人群慢性病患病现况及对社区卫生服务的需求。探索社区卫生服务对60岁及以上人群慢性病的防治对策。方法采用结构式访谈法,对莱社区所有60周岁及以上人群入户进行慢性病患病率和卫生服务需求情况调查。结果该人群慢性病总患病率为68.3%。年龄越大患病率越高。主要以循环系统疾病为主,其次是内分泌、营养和代谢性疾病。前8位慢性病分别是高血压、冠心病、高脂血症、糖尿病、胆结石、脑卒中、慢性支气管炎、慢性咽炎。66.4%的60岁及以上人群有1项及以上社区卫生服务需求。其中以定期体检、健康指导为主。结论立足社区,开展慢性病健康教育和健康促进服务,发展社区卫生服务,提高60岁及以上人群的健康水平和生活质量。  相似文献   

5.
目的调查社区内高血压病分组管理状况,为社区预防控制高血压病提供依据。方法2007年7—9月对徐汇区斜土街道社区≥35岁常住居民进行高血压患病的性别、年龄构成及分组管理的情况进行分析。结果本社区现有高血压管理对象共2052名,其中高血压重点管理对象1917人,男女之比为l:1.22,男性患者中65岁以上者占72.19%,女性患者中65岁以上者占70.77%。其中很多高血压患者伴发有糖尿病、冠心病、脑中风、血脂紊乱等其他慢性疾病。结论高血压病管理是社区卫生服务的重要内容,开展健康教育和健康促进是目前管理和控制高血压的有效方法,管理时应根据患者的不同特点如不同伴随疾病,制定不同的方法和目标,并针对薄弱环节加以改进。  相似文献   

6.
《中国全科医学》2005,8(5):i002-i002
天津市河西区全新启动创建全国社区卫生服务示范区活动.计划2004年基本建成服务网络健全人力配置合理、服务功能完善、监督管理规范.适应社会需求的社区卫生服务体系.使社区卫生服务覆盖率达到100%,家庭责任医生服务覆盖率达80%.社区重点人群管理率达95%.实现社区居民“小病在社区,大病进医院”的目标。  相似文献   

7.
王俊琪 《实用全科医学》2009,7(4):400-400,407
目的探讨对高血压患者实施健康促进对血压控制以及相关因素知晓率的影响。方法在上海市彭浦镇社区卫生服务中心内随机抽取2007年首诊高血压患者95名,对这部分高血压患者进行健康促进,1年后评价干预效果。结果通过近1年的健康促进,入选高血压患者对于高血压诊断标准知晓率、体育锻炼及遗传危险因素知晓率分别从57.89%、38.95%、57.89%上升到74.70%、60.00%、77.89%,上升了近20个百分点.尤其高血压患者血压控制水平在健康促进前后差异有统计学意义(P〈0.01)。结论经过有计划的健康促进,高血压患者的自我保健意识增强,血压水平明显下降,提高了治疗的依从性,对预防并发症意义重大,值得推广。  相似文献   

8.
目的通过城市慢性非传染性疾病综合防治示范社区建设探索以社区为平台,社区卫生服务机构适宜技术用于控制城市社区慢性非传染性疾病发生发展,促进社区参与和提高健康管理水平。方法利用社区卫生服务可及性、连续性、家庭医生服务模式,以社区为基础的一级教育、二级随访、三级治疗分级干预流程和网络;进行信息化条件下社区病例综合管理。结果50~60岁中老年人健康体检结论回顾性评价居民生物危险因素降低了2.87%,其中高血压发生降低了10.99%:高血糖发生降低了2.48%;高血压、糖尿病慢性病新发病例筛查登记下降了17.1%;问卷调查自我血压水平知晓率达到80.4%。结论慢性病的发生和快速发展有效控制除环境因素和生活方式改变外,基层社区卫生服务机构的干预能力是重要的因素,社区的参与配合能够使慢病防控工作做到实处。  相似文献   

9.
成都市社区卫生机构高血压防治能力现状及问题   总被引:2,自引:1,他引:1  
目的 了解成都社区卫生机构高血压防治能力现状及问题。方法标准化问卷,随机整群抽样选取成都市3个城区、1个城乡结合区及一个县级社区共计22个卫生服务中心。结果每万人全科医生、护士数达到国家标准的社区分别为54.30%、28.3%。中心场地面积〈1000m^2的社区达14.20%,高血压最常使用的10项硬件设备普遍具备。平均每个全科医生实际管理高血压患者数不足400人。超过60%社区医生对4类高血压相关知识掌握程度较差。一线降压药物社区使用率不足50%,社区高血压患者从未治疗或间断治疗的分别为18.4%、19.3%。结论社区医生负担过重、高血压患者管理质控不佳是导致迭标率低的重要原因。  相似文献   

10.
高血压患者健康俱乐部的操作模式   总被引:3,自引:2,他引:1  
慢性病系统化管理是社区卫生服务的重要内容,是体现社区卫生服务“以人群为基础、以预防为导向、以人的健康为中心”等基本原则的主要途径。健康俱乐部会员制度是适合在社区中实施而且比较有效的慢性病系统化管理的模式,通过它可针对社区中的各种慢性病患者群(如高血压、糖尿病、癌症等)和特殊人群(如更年期妇女、老年人等)开展全面、全程的健康管理服务,从而有效控制人群的健康危险因素,提高人群的自我保健意识和能力,预防意  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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