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目的:探讨社区年轻高血压个案管理效果。方法:选取2014年10月至2016年10月,在江门市新会区第二人民医院体检或就诊中年龄小于50岁的高血压患者,同意加入个案管理的病例列入为观察组,不同意加入个案管理的列入为对照组,对照组不采取任何干预措施,观察组在社区采取个案管理措施,观察和比较两组患者的治疗依从性、干预前后自我效能SES评量表、生活质量、疾病知识认知水平、遵医行为、血压、血脂等指标的变化。结果:(1)与治疗前对比,治疗后两组患者自我效能和生活质量评分明显提高,差异具有统计学意义(P<0.05)。与对照组对比,观察组治疗依从性明显更高,干预后自我效能、生活质量评分明显更高,差异具有统计学意义(P<0.05)。(2)和对照组对比,观察组对高血压调控的认知水平更高,遵医行为发生率更高,差异具有统计学意义(P<0.05)。(3)和对照组对比,观察组干预后血压水平、总胆固醇、三酰甘油、血尿肌酐更低,高密度脂蛋白、尿酸和尿微量白蛋白/尿肌酐水平更高,差异具有统计学意义(P<0.05)。和治疗前对比,两组干预后血压水平、总胆固醇、三酰甘油、血尿肌酐更低,高密度脂蛋白、尿酸和尿微量白蛋白/尿肌酐水平更高,差异具有统计学意义(P<0.05)。结论:社区年轻高血压个案管理效果显著,能够有效地提高患者的治疗依从性,增加患者对高血压的认识,有利于改善高血压症状,对血压水平进行有效的控制。
Objective: To investigate the management of young hypertensive cases in community. Methods: From October 2014 to October 2016, patients with hypertension who were less than 50 years of age from the second People’s Hospital of Xinhui District in Jiangmen City were enrolled in the case-control group and did not agree Case management was included in the control group, the control group did not take any interventions, the observation group in the community to take case management measures to observe and compare the two groups of patients with compliance, SES self-efficacy after intervention, quality of life, Knowledge of disease knowledge, compliance behavior, blood pressure, blood lipids and other indicators of change. Results: (1) Compared with those before treatment, the self-efficacy and quality of life scores of two groups were significantly improved after treatment, the difference was statistically significant (P <0.05). Compared with the control group, the observation group was significantly higher compliance treatment, self-efficacy after intervention, quality of life scores were significantly higher, the difference was statistically significant (P <0.05). (2) Compared with the control group, the observation group had a higher cognitive level of hypertension regulation and a higher prevalence of compliance, the difference was statistically significant (P <0.05). (3) Compared with the control group, the levels of blood pressure, total cholesterol, triglyceride, serum creatinine, high density lipoprotein, uric acid and urinary albumin / urinary creatinine were higher in the observation group after intervention, the difference was statistically significant (P <0.05). Compared with those before treatment, the levels of blood pressure, total cholesterol, triglyceride, creatinine and serum creatinine were lower in the two groups after intervention, and the levels of high density lipoprotein, uric acid and urine microalbuminuria were higher (P < 0.05). Conclusion: The management of young hypertensive cases in the community is significant, which can effectively improve the treatment compliance and increase the patients’ understanding of hypertension, improve the symptoms of hypertension and control the blood pressure effectively.