乌鲁木齐某社区高血压综合管理效果评价

目的：通过健康教育与高血压慢性病个体化分层管理相结合的综合干预措施,评价社区高血压管理效果,探索高血压慢性病的管理策略.方法收集乌市某社区高血压患者455例.应用试验对照研究,干预组234例和对照组221例,干预组采取为期一年的健康教育与个体化分层管理相结合的综合干预措施,对干预前后进行问卷调查,并对一般人口学特征、生活习惯、医学体检、化验、随访血压、服药状况等进行相关指标检测.结果：1诊断指标：两组患者舒张压差值有统计学意义（p＜0.05）.收缩压及收缩压差比较有统计学意义（p＜0.05）.随访血压监测,依据低、中,高危分组,采用重复测量多元方差分析显示：低危组血压、中危组血压,高危组收缩压均有统计学意义（p＜0.05）.2可控制危险因素：干预组规律性运动,素食为主的比例增加,摄盐量减少,首末腰围差有统计学意义（p＜0.05）.干预组血糖指数降低明显.血脂各项无显著差异.3干预组规律性服药,长效降压药的比例比例增加.结论：社区高血压患者健康教育和分层个体化管理措施能够改善患者血压的不稳定性,降低心血管危险因素,改善了不良生活方式,服药规律性依从性提高,长效降压药使用率增高,加强了社区医生与患者的互动性.但社区高血压患者血压稳定性有待进一步长期的研究.

Effect Evaluation on Hypertension of Comprehensive Management in a Community in Urumqi City

Objectives The purpose of this study was to evaluation effect of hypertensive based on community health service by health education and individual hierarchical comprehensive intervention measures and exploration of chronic hypertension management strategy. Methods used the comparison research method,455 patients with hypertension were divided into intervention goup 234and control group221, Intervention group were given comprehensive measures of health education and individual hierarchical management for One year ,Detection of related indicators, such as the general demographic characteristics before and after the intervention, living habits, risk factors, medical checkups, tests, follow-up blood pressure ,medication situation etc. Results 1. Diagnosis indexes , diastolic blood pressure but the difference was statistically significant （P 〈 0.05）, Two groups of patients with systolic blood pl~ssure was statistically significant （P 〈 0.05）. Follow up blood pressure monitoring, packet low-risk, medimn-risk and high-risk, with repeated measures multivariate analysis of variance showed： blood pressure, low risk group, medium risk group and high risk group systolic blood pressure were statistically significant （P 〈 0.05）. 2 . Control risk , the intervention group increased the proportion of regnlar exercise and light diet, reduced daily salt intake. the waist difference was statistically significant （P 〈 0.05）. Blood glucose, the first and last and differences were statistically significant （P 〈 0.05）, The two groups had no significant change in blood lipids. 3. The intervention group increased the proportion of regular medication and long-acting antihypertensive drug. Conclusion Health