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| 健康管理网络平台在脑卒中合并高血压患者院外延续性健康管理中的应用 |
| 郑静1,胡欢欢1,郑晓红1,李冬梅2*,陆小英2,张玲娟2,张永巍1,杨鹏飞1,李强1,刘建民1 |
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(1. 海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院护理部, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 探讨健康管理网络平台在脑卒中合并高血压患者院外延续性健康管理中的应用及管理成效。方法 收集2018年10月至2020年12月我院脑血管病中心收治的818例合并高血压的急性脑卒中患者资料。根据采用的健康管理方式将患者分为对照组和观察组，其中对照组患者采用常规健康管理方式，即在住院期间予健康风险评估并建立个人健康电子档案，出院时给予常规出院指导，出院后1、3、6和12个月针对性进行脑卒中专题讲座与门诊随访。观察组患者在常规健康管理方式的基础上，基于健康管理网络平台实施12个月的个体化健康管理干预。比较两组患者出院后12个月内药物依从性、血压、生活方式、康复锻炼的自我管理情况。结果 512例合并高血压的脑卒中患者符合纳入和排除标准，其中488例完成随访，包括对照组183例、观察组305例。两组间性别、年龄、脑卒中危险因素差异均无统计学意义（P均>0.05）。与对照组相比，观察组患者出院后12个月内的血压管理达标率没有提升（P=0.135），但药物依从性、生活方式、康复锻炼均有所改善（P均< 0.01）。结论 健康管理网络平台作为一个新型的支撑性脑卒中患者护理平台，能有效提高脑卒中合并高血压患者的院外延续性健康管理质量。 |
| 关键词: 卒中 高血压 健康管理 血压管理 网络平台 |
| DOI：10.16781/j.0258-879x.2022.01.0100 |
| 投稿时间：2021-09-19 |
| 基金项目:上海申康医院发展中心临床研究关键支撑项目（SHDC2020CR6014），上海市卫生和计划生育委员会智慧医疗专项研究项目（2018ZHYL0218） |
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| Application of health management network platform on health management of stroke patients with hypertensionafter discharge |
| ZHENG Jing1,HU Huan-huan1,ZHENG Xiao-hong1,LI Dong-mei2*,LU Xiao-ying2,ZHANG Ling-juan2,ZHANG Yong-wei1,YANG Peng-fei1,LI Qiang1,LIU Jian-min1 |
(1. Neurovascular Center, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Nursing, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the application and effectiveness of health management network platform in the health management of discharged stroke patients with hypertension.Methods The data of 818 acute stroke patients with hypertension treated in Neurovascular Center of our hospital from Oct. 2018 to Dec. 2020 were collected. The patients were assigned to control group or observation group. The patients in the control group received routine health management:the health risks were assessed and individualized health profiles were established during hospitalization, routine discharge instructions were given at discharge, and tailored lectures on stroke and outpatient follow-up were conducted 1, 3, 6 and 12 months after discharge. The patients in the observation group received individualized health management intervention for 12 months using the health management network platform together with the routine health management. The medication adherence, blood pressure management, life style and rehabilitation exercise were compared between the 2 groups within 12 months after discharge.Results A total of 512 stroke patients with hypertension met the inclusion and exclusion criteria, of which 488 patients completed the follow-up, including 183 patients in the control group and 305 in the observation group. There were no significant differences in gender, age or stroke risk factors between the 2 groups (all P>0.05). Compared with the control group, the management of blood pressure within 12 months after discharge was not improved in the observation group (P=0.135), but the medication adherence, life style and rehabilitation exercise were significantly improved (all P < 0.01).Conclusion As a new supporting care platform for stroke patients, health management network platform can effectively improve the quality of health management of stroke patients with hypertension after discharge. |
| Key words: stroke hypertension health management blood pressure management network platform |
