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目的 了解Ⅲ级监护对提高老年人健康的作用。方法 社区内选择486名60岁以上老人,按生活自理能力和患病情况分成Ⅲ级,用Katz分级法对Ⅰ级监护老人生活活动能力的6个方面进行测评。6个月后复测,观察监护前后功能变化。对患有高血压病或糖尿病的Ⅱ级监护老人除了健康教育和行为干预外,进行相关指标(血压、血糖)的监测,观察干预前后血压、血糖变化。在Ⅲ级监护老人中开展健康教育和健康体检。结果 Ⅰ级监护老人中7人生活活动功能有提高,无1例褥疮。Ⅱ级监护老人中136名患有高血压病的老人监护前后收缩压分别为150.44±24.86mmHg和131.88±11.56mmHg(t检验=7.96,P<0.001),舒张压分别为87.39±4.39mmHg和77.43±2.47mmHg,差别有统计学意义(t检验=23.11,P<0.001),45名糖尿病人干预后,血糖总控制率为64.45%(包括理想控制和一般控制)。收缩压平均降低了19mmHg,舒张压平均降低了10mmHg。Ⅲ级监护的老人体检后,新发现高血压20人,糖尿病5人,转入Ⅱ级监护。348名Ⅱ、Ⅲ级老人培训后,高血压知识知晓率明显提高。结论 Ⅲ级监护全科医疗服务对提高老年人健康有积极作用。
Objective To understand the role of Ⅲ-level monitoring in improving the health of the elderly. Methods A total of 486 elderly people over the age of 60 were selected in the community. The patients were divided into three groups according to their ability to take care of themselves and the prevalence of disease. The Katz grading method was used to evaluate six aspects of living activities of grade I elderly people. Retest 6 months later, observe the changes in the guardianship before and after. In addition to health education and behavioral intervention, Ⅱ-level elderly people with hypertension or diabetes mellitus were monitored for blood pressure and blood glucose, and blood pressure and blood glucose were observed before and after intervention. In Ⅲ-level care of the elderly to carry out health education and physical examination. Results Among 7 grade I elderly caregivers, the activities of living activities were improved and none of the bedsores were found. The systolic blood pressure of 136 senile hypertensive patients with grade Ⅱ care was 150.44 ± 24.86mmHg and 131.88 ± 11.56mmHg respectively before and after monitoring (t test = 7.96, P <0.001), and the diastolic blood pressure was 87.39 ± 4.39mmHg and 77.43 ± 2.47mmHg, the difference was statistically significant (t test = 23.11, P <0.001). After the intervention of 45 diabetic patients, the total blood glucose control rate was 64.45% (including ideal control and general control). Systolic blood pressure decreased by an average of 19mmHg, diastolic blood pressure decreased by an average of 10mmHg. Ⅲ-level custody of the elderly after the examination, the newly discovered high blood pressure 20 people, 5 people with diabetes, transferred to Ⅱ-level care. 348 Ⅱ, Ⅲ-level elderly training, knowledge of hypertension significantly increased awareness. Conclusion Grade III care GP has a positive effect on improving the health of the elderly.