肖　烨　岳　涛　李　郁　娄邦秀四川省绵阳市中心医院心脏中心，四川绵阳　621000

动态血压监测在非识字老年高血压患者服药指导中的应用

肖烨岳涛李郁娄邦秀
四川省绵阳市中心医院心脏中心，四川绵阳621000

目的 探讨动态血压监测在非识字老年高血压患者服药指导中的应用效果。方法 选择2013年12月～2015年8月在绵阳市中心医院心内科接受住院治疗的非识字老年高血压患者152例为研究对象，采用随机数字表法，将患者分为对照组和观察组，每组各76例。对照组采用常规的管理，给予用药知识指导，讲解药物作用及副作用。观察组通过动态血压监测，分析血压高峰时间，对患者进行形象思维、时间，以及生活习性等相联系的服药指导。分析比较两组患者的服药依从性、对高血压疾病知识的掌握情况，以及血压变化情况。结果 两组患者的服药依从性好者占比（89.47%）高于对照组（65.79%），差异有统计学意义（χ2=7.204，P＜0.05）。观察组高血压疾病知识的掌握者占比（81.6%）明显高于对照组（60.5%），差异有统计学意义（χ2=4.094，P＜0.05）；入院及出院时两组患者的血压比较，差异无统计学意义（P＞0.05）；出院1年后对照组SBP及DBP均高于观察组，差异有统计学意义（χ2=6.534、4.897，均P＜0.05）。结论 通过动态血压监测分析，科学指导非识字老年高血压患者服药时间，可有效控制患者的血压，提高其服药依从性，减少并发症的发生。

动态血压；非识字；老年；高血压

［Abstract］Objective To explore the effect of ambulatory blood pressure monitoring in the medication guide of non-literate elderly patients with hypertension.Methods From December 2013 to August 2015，152 non-literate elderly patients with hypertension in the Department of Cardiology of the Central Hospital of Mianyang were selected，according to the random number table method，patients were randomly divided into control group and observation group，76 cases in each group.Control group was given the routine management，such as the explanation of medication knowledge guidance，drug action and side effects.Hours of blood pressure peak of patients in observation group was analyzed through ambulatory blood pressure monitoring，image thinking，time and life habits associated medication guide were carried among those patients.Medication compliance，knowledge of hypertension disease and blood pressure control of patients in the two groups were analyzed and compared.Results Proportion of patients with better medication adherence in observation group（89.47%）was higher than that of the control group（65.79%），the difference was statistically significant（χ2=7.204，P＜0.05）.Proportion of patients who grasp the knowledge of hypertension disease of the observation group（81.6%）was higher than control group（60.5%），the difference was statistically significant（χ2=4.094，P＜year after discharge SBP and DBP of the control group were higher than those of the observation group，the differences were statistically significant（χ2=6.534，4.897，all P＜0.05）.Conclusion Through the analysis of ambulatory blood pressure monitoring，scientific guidance for medication time of non-literate elderly patients with hypertension，effectively control the blood pressure，improve the medication compliance，and reduce complications.

［Key words］Ambulatory blood；Non-literate；Elderly；Hypertension

高血压是最常见的心血管疾病，老年高血压患者在长期治疗过程中较多患者未按医嘱服药，高血压控制率仅为6.1%，治疗效果和生活质量受到严重影响，知晓率与治疗率低是导致该问题的关键［1］，李霞等［2］研究结果显示，农村老年高血压患者服药依从性差者所占比例为70.5%，与其文化程度低有关。……