發(fā)布時(shí)間：2018-04-07 17:15

  本文選題：社區(qū)衛(wèi)生服務(wù)　切入點(diǎn)：慢性病　出處：《中國(guó)全科醫(yī)學(xué)》2017年05期

【摘要】：目的基于北京市社區(qū)慢病患者的危險(xiǎn)因素,測(cè)算心腦血管疾病患病風(fēng)險(xiǎn),分析慢病管理的形勢(shì)與挑戰(zhàn),比較城鄉(xiāng)差別,提出加強(qiáng)社區(qū)慢病管理的對(duì)策。方法根據(jù)分層整群抽樣原則,于2015年9月分別對(duì)北京市西城區(qū)1個(gè)城市街道和平谷區(qū)1個(gè)農(nóng)村鄉(xiāng)鎮(zhèn)的社區(qū)衛(wèi)生服務(wù)中心進(jìn)行現(xiàn)場(chǎng)調(diào)研,納入兩個(gè)社區(qū)衛(wèi)生服務(wù)中心管理的所有高血壓、糖尿病患者7 535例作為研究對(duì)象。運(yùn)用世界衛(wèi)生組織(WHO)/國(guó)際高血壓學(xué)會(huì)(ISH)心腦血管疾病風(fēng)險(xiǎn)預(yù)測(cè)圖對(duì)未患心腦血管疾病者未來(lái)10年發(fā)生心腦血管疾病的風(fēng)險(xiǎn)進(jìn)行測(cè)算。結(jié)果回收有效問(wèn)卷7 215份,有效回收率為95.75%。其中城市3 589例,農(nóng)村3 626例。未患心腦血管疾病者4 378例,其中城市1 796例,農(nóng)村2 582例。城市和農(nóng)村慢病患者年齡、吸煙率、慢病分布、高脂血癥患病率、體質(zhì)指數(shù)(BMI)≥23 kg/m2所占比例比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。未患心腦血管疾病者患心腦血管疾病風(fēng)險(xiǎn)10%(低風(fēng)險(xiǎn))、10%~19%(中風(fēng)險(xiǎn))、20%~29%(高風(fēng)險(xiǎn))、30%~40%(高風(fēng)險(xiǎn))和40%(高風(fēng)險(xiǎn))分別為2 342例(53.49%)、953例(21.77%)、815例(18.62%)、186例(4.25%)和82例(1.87%)。城市患病風(fēng)險(xiǎn)高于農(nóng)村,差異有統(tǒng)計(jì)學(xué)意義(χ~2=171.665,P0.05)�；颊叩惋L(fēng)險(xiǎn)、中風(fēng)險(xiǎn)、高風(fēng)險(xiǎn)和已患心腦血管疾病者分別為2 342例(32.46%)、953例(13.21%)、1 083例(15.01%)和2 837例(39.32%)。城市患者中,已患心腦血管疾病者為1 793例(49.96%)。結(jié)論社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)在高危患者管理中發(fā)揮著重要作用;社區(qū)心腦血管疾病形勢(shì)嚴(yán)峻,城市任務(wù)更艱巨;需強(qiáng)化分級(jí)診療與分工協(xié)作,深化社區(qū)慢病管理,提高社區(qū)醫(yī)患雙方的風(fēng)險(xiǎn)管理意識(shí)。
[Abstract]:Objective to calculate the risk of cardiovascular and cerebrovascular diseases, analyze the situation and challenges of chronic disease management, compare the differences between urban and rural areas, and put forward the countermeasures to strengthen the management of chronic disease in community based on the risk factors of chronic disease patients in Beijing.Methods according to the principle of stratified cluster sampling, the community health service centers of one city street in Xicheng District and one rural town in Pinggu District of Beijing were investigated in September 2015.A total of 7,535 patients with hypertension and diabetes were included in the study.The risk of cardiovascular and cerebrovascular diseases in patients without cardiovascular and cerebrovascular diseases in the next 10 years was estimated by using WHO / ISH (World Health Organization / International Hypertension Society).Results 7 215 valid questionnaires were collected and the effective recovery rate was 95.75.There were 3 589 cases in cities and 3 626 cases in rural areas.There were 4 378 cases without cardiovascular and cerebrovascular diseases, including 1 796 cases in urban areas and 2 582 cases in rural areas.Age, smoking rate, distribution of chronic diseases, prevalence of hyperlipidemia and BMI 鈮，

本文編號(hào)：1720106