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目的探讨分别在上海地区社区卫生服务中心和三级医院就诊的缺血性脑卒中患者的危险因素分布特点。方法在上海地区1所三级教学医院(三级医院组)和7个社区卫生服务中心(社区卫生服务中心组)设立脑卒中二级预防门诊,收集连续就诊的资料完整的缺血性脑卒中患者1770例,记录其人口学资料、血管性危险因素及不良生活方式,分析各个危险因素的百分比、危险因素的累积数目及危险因素组合。结果社区卫生服务中心组高血压、糖尿病、心脏疾病和脑卒中患者的构成比均显著高于三级医院组(P值均<0.01),而血脂异常、吸烟、饮酒、缺乏锻炼患者的构成比则显著降低(P值均<0.01)。三级医院组患者中伴有多个危险因素的构成比显著高于社区卫生服务中心组(P<0.01),高血压伴糖尿病患者的比例显著降低(P<0.01)。结论在缺血性脑卒中二级预防的工作中,要加强危险因素的筛查,对在社区卫生服务中心就诊的患者需要给予积极的危险因素有效药物控制,而对在三级医院就诊的患者则应重视生活方式的干预。
Objective To investigate the distribution of risk factors in ischemic stroke patients in community health centers and tertiary hospitals in Shanghai. Methods Stroke secondary prevention clinics were set up in 1 tertiary teaching hospital (tertiary hospital group) and 7 community health service centers (community health service centers) in Shanghai area to collect data on complete treatment of ischemic stroke 1770 patients were recorded demographic data, vascular risk factors and unhealthy lifestyles, analysis of the percentage of risk factors, the cumulative number of risk factors and risk factors combination. Results The proportions of patients with hypertension, diabetes mellitus, heart disease and stroke in community health service center were significantly higher than those in tertiary hospital (P <0.01), while those with dyslipidemia, smoking, alcohol consumption and lack of exercise Was significantly lower (P <0.01). The proportions of multiple risk factors in tertiary hospitals were significantly higher than those in community health service centers (P <0.01), and the proportion of hypertensive patients with diabetes was significantly lower (P <0.01). Conclusions In the secondary prevention of ischemic stroke, screening for risk factors should be stepped up. Patients in community health service centers need to be given effective active drug control for risk factors. Patients in tertiary hospitals You should pay attention to lifestyle interventions.