朱清艳 吕鹏 王睿 刘玉

摘 要 目的：建立和評价基于微信公众平台的社区高血压自我管理干预模式。方法：选取2019年1月至3月在上海市嘉定区南翔镇社区卫生服务中心就诊的高血压患者为研究对象，随机分为对照组（105例）和干预组（108例）。对照组中男性78例，占74.3%，女性27例，占25.7%；平均年龄（63.74±9.18）岁。干预组中男性76例，占70.4%，女性32例，占29.6%；平均年龄（63.16±9.13）岁。对照组患者接受社区高血压分级管理，对干预组患者通过微信公众平台实施社区高血压自我管理干预。干预时间为6个月。比较两组患者干预前、后的自我管理行为、自我效能、健康功能状况，并观察两组患者血压变化及控制情况。结果：干预结束后，两组患者自我管理行为中的耐力锻炼时间、认知性症状管理、医患交流、食盐摄入评分和自我效能中的症状管理、疾病共性管理评分差异均有统计学意义（P<0.05）。干预后，干预组患者的收缩压和舒张压水平明显低于对照组（P<0.01），血压达标率显著高于对照组（P<0.01）。结论：利用微信公众平台开展高血压自我管理有利于改善社区高血压患者自我管理行为，提高自我效能，改善血压控制的效果。

关键词 高血压；微信公众平台；自我管理；血压控制

中图分类号：R544.1 文献标志码：A 文章编号：1006-1533（2021）02-0047-04

*基金项目：上海市嘉定区卫生和计划生育委员会青年项目资助（2017-QN-10）

Establishment and evaluation of self-management mode of the community hypertension based on Wechat interactive management platform

ZHU Qingyan， Lyu Peng， WANG Rui， LIU Yu

（The Third Team of Nanxiang Community Health Service Center of Jiading District， Shanghai 201802， China）

ABSTRACT Objective： To establish and evaluate self-management mode of the community hypertension based on WeChat public platform. Methods： Patients with hypertension who visited Nanxiang Community Health Service Center of Jiading District of Shanghai from January to March 2019 were selected as the research objects， and randomly divided into a control group with 105 cases and an intervention group with 108 cases. The control group had 78 males， accounting for 74.3% and 27 females， accounting for 25.7%； the average age was （63.74 ±9.18） years old. The intervention group had 76 males， accounting for 70.4% and 32 females， accounting for 29.6%； the average was （63.16 ±9.13） years old. The patients in the control group adopted the regular grading management of hypertension in the community， and the intervention group accepted hypertension self-management intervention by using the WeChat public platform. The intervention time was 6 months. The self-management behavior， self-efficacy， and health function status were compared and blood pressure change and control were observed in the patients of the two groups. Results： After the intervention， there were significant differences in the scores of aerobic exercise time， cognitive symptom management， communication between the medical personnel and the patients and salt intake， symptom management in the self-management behavior， and common disease management（P<0.05）. Both systolic and diastolic pressures were markedly lower in the intervention group than those in the control group（P<0.01）， and the blood pressure target achievement in the intervention group was obviously higher than that in the control group （P<0.05）. Conclusion： Hypertension self-management by using the WeChat public platform is benefit for improving the self-management behaviors， the self-efficacy and the efficiency of blood pressure control in patients with hypertension in the community.

KEY WORDS hypertension； WeChat public platform； self-management； blood pressure control

目前我国高血压患病人数已接近3亿，且还在持续上升[1]。高血压作为一种常见慢性病，病程相对较长，后期存在多种并发症，是心脑血管病最主要的危险因素。规范的管理和有效的健康宣教，可以改善高血压患者的临床症状，满足患者治疗和管理需求[2]。而传统的健康宣教方式受时间、空间的限制；文字枯燥，患者理解力较差；需要有一对一的医生指导；经济成本相对较高等[3]。虽然分级管理模式在社区高血压管理上起到了很好的效果，但面臨高血压患病人数连续上升和社区医疗资源相对不足的现状。……