农村社区人群心脑血管病综合防治效果评价
Effect of community-based comprehensive prevention and control on cardio-cerebro-vascular disease in rural areas
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摘要:目的 了解心脑血管病(CVD)综合防治措施在社区实施的效果以及所需的卫生成本, 总结适合农村社区CVD综合防治的工作模式。方法 对古镇社区6.3万人口进行以社区为基础的CVD综合防治干预, 内容包括高血压管理、控烟、合理营养、全民健身运动及糖尿病管理等。结果 通过10年的干预, 全人群血压知晓率为70.29%高血压管理率和控制率逐年提高, 其中管理率达到80.50%, 总控制率达到45.80%, 而血压 < 160/95mmHg控制率为58.80%, 血压 < 140/90mmHg控制率为32.80%;干预点社区人群收缩压和舒张压水平均下降, 其差值分别为7.23mmHg和3.92mmHg; 全人群CVD相关知识、态度及行为(KAB)水平明显提高; 全人群脑卒中发病率和死亡率呈逐年下降趋势, 分别由1997年的146.90/10万和10863/10万下降到2002年的105.83/10万和69.90/10万, 6年来分别减少了41.07/10万和38.73/10万, 且发病年龄后移; 经济学分析表明, 1997~2001年的平均效益-成本比为2.32。结论 以社区为基础的CVD综合防治是有效的, 但尚需加大干预力度和广度。Abstract:Objective To evaluate the effectiveness of community-based comprehensive prevention and control on cardio-cerebro-vascular disease(CVD)in large scale population through interventions with high efficacy.Methods Guzhen community with 63 thousands of population were selected for interventions, which included hypertension management, balance nutrition, smoking control and diabetes management.Results After 10-year interventions, the rates of awareness, management and control of hypertension were 70.29%, 80.50% and 45.80% respectively.The levels of blood pressure among intervention site were reduced by 7.23 mmHg for systolic blood pressure and 3.92 mmHg for diastolic blood pressure.The levels of CVD related knowledge, attitude and behavior(KAB)were increased clearly.The incidence and mortality of stroke were downtrend year after year, and reduced 41.07/100 000 and 38.73/100 000 respectively in six years.While the incidentage was postponed.The economic analyses made known that the ratio of benefit-cost was 2.32 mean.Conclusion Community-based comprehensive prevention and control on CVD was effective, but the power and extent of interventions must be enhanced.
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