家庭自测血压管理对老年高血压病人血压控制和改善生活质量的效果分析

摘要

目的 探讨家庭自测血压管理对老年高血压病人血压控制的干预效果. 方法 收集362例老年高血压病人,随机分为2组,每组181例.家庭自测血压组进行家庭自测血压干预6月,每日定时测量3次,每周门诊测量血压1次,血压＜ 140/90 mmHg视为达标,对照组未进行家庭自测血压.记录干预期间病人高血压并发症的发生情况.干预前后分别进行病人生活质量评分,并在干预后进行依从性评分. 结果 研究结束时,家庭自测血压组还有病人160例,对照组有168例.干预后,家庭自测血压组的收缩压(P=0.011)、舒张压(P=0.038)较对照组显著降低,血压达标率显著高于对照组(P＜0.001),并发症发生率显著低于对照组(P＜0.001).干预后,家庭自测血压组病人的遵医行为、服药行为、日常生活管理、烟酒嗜好以及总评分显著高于对照组(P＜0.05);生活质量评分结果提示,其生理机能、心理职能、一般健康状态、精神健康评分亦高于对照组(P＜0.05). 结论 家庭自测血压是协助降压治疗的有效手段,可提高病人依从性,减少并发症发生,提高病人生活质量.%Objective To explore the effects of home blood pressure (BP) monitoring on blood controlling and life quality in elderly hypertensive patients.Methods 362 elderly hypertensive patients were recruited in the study and randomly divided into home BP monitoring group (interventional group) and control group according to whether they undernent home BP monitoring.The interventional group underwent home BP monitoring for 6 months,with 3 times per day.Outpatient BP was measured 1 time per week.The controlling target of BP was lower than 140/90mmHg.The hypertensive complications were recorded during the intervention.Life quality was evaluated before and after intervention,and the compliance score was recorded after intervention.Results 160 patients in interventional group and 168 patients in control group were followed up until the end of the study respectively.After 6 months' intervention,both systolic pressure (P=0.011) and diastolic pressure (P=0.038) of interventional group were significantly lower than those of control group,and the BP target rate of interventional group was higher than that of control group (P＜0.001).Additionally,the incidence rate of complications in interventional group was lower (P＜0.001) than that of control group.The scores in following doctor's instruction,taking medicine,daily life administration,hobbies of tabacoo and wine and the total score in interventional group were significantly higher than those in control group (P＜0.05).Meanwhile,the scores of physiological functions,psychological functions,general healthy status and mental health in interventional group were also higher than those in control group (P＜ 0.05).Conclusions Home BP monitoring is effective to assist in lowering BP of hypertensive patients,which is able to improve the patients' compliance,decrease the occurrences of hypertensive complications and improve the life quality.