社區(qū)輕型老年高血壓患者社區(qū)護(hù)理干預(yù)研究

論文編號(hào):HL090  論文字?jǐn)?shù):8549.頁數(shù):24

論文題目：社區(qū)老年輕度高血壓患者社區(qū)護(hù)理干預(yù)研究
摘 要
研究背景
 高血壓是老年人最常見的心血管病,是全球范圍內(nèi)的重大公共衛(wèi)生問題。原發(fā)性高血壓是腦卒中、冠心病和心腎功能衰竭的主要發(fā)病因素（1）。國務(wù)院2004年公布資料顯示，我國成人高血壓患病率已達(dá)18.8%，高血壓流行呈低知曉率、低治療率、低控制率現(xiàn)狀，因此，盡早發(fā)現(xiàn)，積極防治，力爭(zhēng)使高血壓患者的血壓達(dá)到理想標(biāo)準(zhǔn),是抗高血壓治療的基本要求，國內(nèi)外的經(jīng)驗(yàn)表明，控制高血壓最有效的方法是社區(qū)綜合防治（2）。社區(qū)綜合防治是當(dāng)前我國心腦血管疾病綜合防治工作中的中心環(huán)節(jié)，是一項(xiàng)低投入、高產(chǎn)出、高效益的衛(wèi)生保健事業(yè)，在社區(qū)中開展高血壓健康教育可大大提高社區(qū)人群對(duì)高血壓知曉率和控制率,延緩病情進(jìn)展,降低復(fù)發(fā)率,減少并發(fā)癥,減輕疾病負(fù)擔(dān),提高生活質(zhì)量（3、4、5）。。社區(qū)輕型高血壓，由于其主要是患者未受到心、腦、腎和眼底器質(zhì)性損害,與正常血壓和確診高血壓之間存在可轉(zhuǎn)化型。輕型高血壓是持續(xù)性高血壓的前驅(qū),并影響其發(fā)生和發(fā)展。
研究目的
 探討通過社區(qū)綜合干預(yù)措施對(duì)輕型老年高血壓患者進(jìn)行干預(yù)從而控制血壓，達(dá)到在社區(qū)居民中提倡和推廣社區(qū)綜合護(hù)理干預(yù)的目的。
研究方法
 按隨機(jī)原則選擇248例社區(qū)輕型老年高血壓患者，排除了糖尿病、冠心病、肥厚性心肌病、心力衰竭、主動(dòng)脈瓣狹窄、過速性心律失及腎功能不全等疾病的人群，通過對(duì)人群建立居民健康檔案，開展健康教育宣傳、進(jìn)行健康行為指導(dǎo)，合理膳食、低鹽飲食、戒煙限酒、保持良好的情緒，并進(jìn)行適量的體育鍛煉，連續(xù)監(jiān)測(cè)血壓，與干預(yù)前后進(jìn)行對(duì)比分析。
研究結(jié)果
1. 在老年高血壓患者進(jìn)行護(hù)理干預(yù)前，患者對(duì)高血壓的知曉率、低鹽低脂飲食率、適量運(yùn)動(dòng)率都比較低，通過我們對(duì)高血壓患者有計(jì)劃、有組織、有系統(tǒng)的綜合干預(yù)后，患者對(duì)高血壓知識(shí)均有很大程度的掌握，知曉率為90.8%，低鹽低脂飲食率達(dá)53.2%，適量運(yùn)動(dòng)率為76.2%。
 2. 選擇的172輕度高血壓老人經(jīng)過干預(yù)發(fā)現(xiàn)1個(gè)月后血壓正常者有41例(24.1%),干預(yù)2個(gè)月后血壓正常者有61例(35.2%),干預(yù)3個(gè)月后血壓正常者73例（42.5%）
結(jié)論
對(duì)社區(qū)老年輕度高血壓患者進(jìn)行社區(qū)綜合護(hù)理干預(yù)，加強(qiáng)高血壓基礎(chǔ)、病因、臨床癥狀知識(shí)等內(nèi)容的健康教育十分必要，健康促進(jìn)和健康教育可以通過影響人的知識(shí)、態(tài)度來改變?nèi)说男袨? 同時(shí)進(jìn)行運(yùn)動(dòng)鍛煉、營(yíng)養(yǎng)干預(yù)、放松訓(xùn)練等社區(qū)護(hù)理干預(yù)等可以有效的降低血壓，降低患者服藥的并發(fā)癥和減少患者的經(jīng)濟(jì)負(fù)擔(dān)。
關(guān)鍵詞：高血壓    社區(qū)護(hù)理    干預(yù)措施
論文類型：研究報(bào)告

 Thesis subject:Community old-age light degree high blood pressure sufferer the community nursing interfere a search
 
 
 
 Abstract
 Study back ground
      The high blood pressure is old people's most familiar cardiovascular disease, the great public hygiene question in range in the world. The hair high blood pressure was a brain at first the soldier won, coronary and core kidney function crocked up of main outbreak factor.(1) State council releases data display in 2004, our country adult's high blood pressure fall ill rate already 18.8%, the high blood pressure fad presents low understand a rate and low treatment of rate, low control rate present condition, therefore, as early as possible discover, actively prevention and cure, work hard for the blood pressure of making the high blood pressure sufferer to hit ideal standard, is an anti- high blood pressure the fundamental request of treatment, domestic and international experience enunciation, controling the most useful method of high blood pressure is a community synthesis to prevent and cure.(2) Community's synthesizing prevention and cure is current our country the core link in the centre within cerebral disease synthesis preventing and curing is a low invest, high output - input ratio, efficiently the health care business of benefit, develop high blood pressure health education in the community can consumedly raise the community crowd understands rate and control rate to the high blood pressure and defers condition progress and lowers to relapse a rate and reduces complications and lightens disease burden, exaltation life mass.(3, 4, 5).Community light high blood pressure, because it mainly is a sufferer don't be injured by core, brain, kidney and the eye bed machine guilder, with normal blood pressure and confirm the existence of high blood pressure can conversion type.The light high blood pressure is the forerunner of continuity high blood pressure, and effect its occurrence and shape.
 
 Study a purpose
 Inquire into passing the community synthesis interruption measure to carry on an interruption to control blood pressure thus vs the light old-age high blood pressure sufferer and hit in the community to promote and expand community to synthesize the purpose of nursing interruption in the resident.
 
 Study a method
 According to random priniple select 248 community light old-age high blood pressure sufferer, expeled diabetes, coronary, fatty thick sex myocardial disease, the mental exertion crock up, the aorta petal is narrow, the overspeed core Lyu lose and renal insufficiency of etc. paroxysm crowd, pass vs crowd create resident healthy file, develop healthy education publicity and carry on healthy behavior instruction, reasonable meal, low salt food, quit smoking to limit wine and keep good emotion, and carry on just the right amount of athletics to toughen, continuous monitor blood pressure, contrast analysis with progress in the front and back of the interruption.
 
 Study a result
Before the old-age high blood pressure sufferer carries on a nursing interruption, the sufferer understands rate and low salt and low fat food vs the high blood pressure rate and just the right amount of running rate is all lower, after passing us to having program to the sufferer of high blood pressure and have the organization, systematic synthesis the interruption, the sufferer has the keep in hand of very great degree to all the high blood pressure knowledge and understands to lead to 90.8%, the low salt and low fat food leads up to 53.2%, and just the right amount running leads to 76.2%.
Choice 172 mild hypertension old person the intervention discovered 1 month later the blood pressure normal person has 41 examples (24.1%), intervenes 2 months later the blood pressure normal person has 61 examples (35.2%), intervenes 3 months later blood pressure normal person 73 examples (42.5%)
 
 Conclusion
 Carry on community synthesis vs the old-age light degree high blood pressure sufferer of community nursing interruption, intensify contents sc, such as high blood pressure foundation, cause of disease and clinical symptom knowledge...etc. of healthy education full a necessity, healthily accelerate and healthily education can pass the knowledge of effecting the person, attitude to transform the person's behavior, progress running toughens at the same time, nourishment interruption, relax training etc. community nursing interruption etc. can useful step - down blood pressure, lower the economic burden of complications and decrease sufferer that the sufferer takes a medicine.
 
 Keyword:High blood pressure    Community nursing    Interfere measure
 Thesis type:Research paper

目  錄
1前言 1
 1.1研究背景及意義 1
 1.2研究目的及目標(biāo) 1
 1.2.1研究目的 1
 1.2.2研究目標(biāo) 1
 1.3關(guān)鍵詞及意義 2
     1.3.1高血壓 2
     1.3.2社區(qū)護(hù)理 2
     1.3.3干預(yù) 2
    1.4文獻(xiàn)回顧 2
 1.4.1高血壓病的病因和主要的發(fā)病機(jī)制 2
         1.4.1.1遺傳因素 2
         1.4.1.2飲食 3
 1.4.1.3精神因素 3
 1.4.1.4體重因素 3
 1.4.1.5吸煙 3
 1.4.1.6血清游離脂肪酸 3
 1.4.1.7血管緊張素Ⅱ 4
 1.4.1.8阻塞性睡眠呼吸暫停綜合征 4
2研究設(shè)計(jì)與方法 5
 2.1研究設(shè)計(jì) 5
 2.2 研究對(duì)象 5
     2.2.1研究對(duì)象 5
 2.2.2納入標(biāo)準(zhǔn) 5
     2.2.3排除標(biāo)準(zhǔn) 5
 2.3研究步驟 5
 2.4資料分析 7
3結(jié)果 9
 3.1干預(yù)前后高血壓知曉率比較 9
 3.2干預(yù)前后低鹽低脂生活率比較 9
    3.3干預(yù)前后適量運(yùn)動(dòng)率比較 9
    3.4三個(gè)月降壓控制率 10
4討論 11
5結(jié)論 13
 5.1研究結(jié)論 15
 5.2不足和建議 15
致謝 15
參考文獻(xiàn) 17