以家庭为单位进行高血压病防治和管理的效果评价

目的探讨以家庭为单位进行高血压病防治和管理的效果。方法从2006年1月开始将由普查、体检、门诊、急诊治疗、住院检出高血压及区妇幼保健院、区疾控中心转诊来的高血压患者中,在知情同意并配合管理的基础上选取社区原发性高血压患者200人,并分为2组,每组100人,一组为家庭组,另一组为对照组。家庭组高血压患者进行分级管理,对病人及其家属进行系统的健康教育,指导并由家庭成员督促高血压病人控制体重、戒烟限酒、低盐低脂饮食、适当锻炼、控制情绪、避免过劳、按时吃药、提醒他们定期复诊,并结合病人实际建立可行的个体化药物与非药物治疗措施相结合的长期诊疗方案。对照组则进行常规治疗。在干预治疗两年后比较两组的①服药率、治疗率、血压控制率;②不良生活习惯及行为的改变情况;③对高血压知识掌握程度;④新增心、脑、肾等靶器官的损害发生率、致残率及死亡率。结果经过干预后的家庭组高血压患者在家庭成员的监督和紧密配合下,该组高血压知识掌握率、高血压治疗率和控制率明显上升,吸烟、酗酒、高盐高脂饮食、高血糖、肥胖、少运动等高血压危险因素呈下降趋势,新增心脑血管事件及其所致的致残率、死亡率则低于对照组。结论以家庭为单位进行高血压病防治和管理有效、可行。

THE EFFECT EVALUATION OF THE PREVENTION,TREATMENT AND MANAGEMENT OF IDIOPATHIC HYPERTENSION BASED ON FAMILY

Objective To evaluate the effect of prevention, treatment and management of idiopathic hypertension based on family. Methods Since January of 2006, the 200 Community idiopathic hypertension patients, who came from Sanshui people＇ s hospital, Sanshui Centre for Disease Control and Prevention and maternity and children＇ s health care center with informed consent and good compliance, were averagely divided into family group and the control group. The classification management, educating the patients and their family members systematically and made their family members urge the patients control weight, give up smoking and restrict liquor, low salt and lipid diet,exercise, control emotion,avoid strain, take medcine on time and follow up regularly and establish individual curing measures ,was performed in the family group. The routine therapy was performed in the control group. 2 years later,the rate of taking medcine,curing and control,the change of bad life habits and behavior,the level of mastering hypertension knowledge and the rate of target organ damage, the diabllng rate and mortality were compared in the two groups. Results The rate of mastering hypertension knowledge, the control and curing rate of hypertension were higher and the hypertension risk factors such as smoking,excessive drinking, excessive salt and lipid diet, hyperglycemia, obesity,lacking exercise and so on,and the diabling rate and mortality were lower in the family group than in the control group. Conclusion The prevention,treatment and management of idiopathic hypertension based on familyare effective and feasible.