全家庭血压管理对提高高血压患者治疗依从性的研究

张世娜，李健，钱烨，毛轶鸣，蔡陆施，徐冠来，陆勇，徐雷上海市虹口区广中路街道社区卫生服务中心，上海　200083

全家庭血压管理对提高高血压患者治疗依从性的研究

张世娜，李健，钱烨，毛轶鸣，蔡陆施，徐冠来，陆勇，徐雷
上海市虹口区广中路街道社区卫生服务中心，上海200083

目的 了解家庭医生利用家庭血压监测（HBPM）对高血压患者治疗依从性的影响，为日后制定干预措施提供可信依据。方法 采用问卷调查法，择取本社区卫生服务中心门诊的105例高血压患者进行调查，①根据有无家庭HBPM情况，将上述病患分为监测组和未监测组，其中监测组81例，未监测组24例；②在监测组中，根据监测的频率次数，又分为常测组（27例）、周测组（26例）和偶测组（28例）；对上述各组进行依从性分析评分。结果 ①与未监测组相比，监测组患者的依从性较高（P＜0.05）；与偶测组相比，周测组患者的依从性较高（P＜0.05）；与周测组相比，常测组患者的依从性较高，差异有统计学意义（P＜0.05）。②与偶测组相比，周测组患者的舒张压及收缩压均明显降低（P＜0.05）；与周测组相比，常测组患者的舒张压及收缩压均明显降低，差异有统计学意义（P＜0.05）。结论 家庭HBPM能够提高高血压病人的治疗依从性及其血压的控制水平，并且有助于增强患者的参与意识，从而使患者的血压指数稳定在某一安全水平，值得临床推广。

高血压；家庭血压监测；依从性

［Abstract］Objective To know the effect of home blood pressure monitoring used by family doctors for whole-family blood pressure management on improving the treatment compliance of patients with hypertension and provide credible basis for making intervention measures in the future.Methods 105 cases of patients with hypertension in the out-patient clinics of health service center in community were selected for survey by the questionnaire，and divided into the monitoring group with 81 cases and no monitoring group with 24 cases，and the monitoring group were divided into the routine monitoring group with 27 cases，week monitoring group with 26 cases and even monitoring group with 28 cases，and the compliance of the above each group was analyzed and scored.Results The compliance in the monitoring group was higher than that in the no monitoring group，P＜0.05，the compliance in the week monitoring group was higher than that in the even monitoring group，P＜0.05，the compliance in the routine monitoring group was higher than that in the week monitoring group，and the difference had statistical significance，P＜0.05，the diastolic and systolic blood pressures obviously decreased in the week monitoring group compared with those in the even monitoring group，P＜0.05，and the diastolic and systolic blood pressures obviously decreased in the routine monitoring group compared with those in the week monitoring group，and the differences had statistical significance，P＜0.05.Conclusion The home blood pressure monitoring can improve the treatment compliance and blood pressure controlling level in patients with hypertension and contributes to enhancing the participation awareness of patients thus stabilizing the blood pressure indicator of patients at a certain safety level，which is worth clinical promotion.

［Key words］Hypertension；Home blood pressure monitoring；Compliance

高血压是常见的长期慢性病之一，也是心脑血管类疾病病发的主要诱因。高血压常伴有心肌梗死、心力衰竭、慢性肾病及脑出血等并发症，此类并发症死亡率极高，不仅给患者的身心带来了极度的痛苦而且也给其家庭带来了沉重的负担［1-2］。……