全程综合护理干预对提高心肌梗死患者依从性及预后的研究

Study on the Effect of Multi-factorial Optimized Holistic Nursing on Medication Adherence and Cardiovascular Events of Patients with Myocardial Infarction

目的:探讨全程综合护理干预对心肌梗死患者遵医行为及预后的影响。方法:100例心肌梗死患者随机分为对照组及全程综合护理组,每组各50例。对照组实施传统的常规护理,综合护理组患者开展全程综合护理。出院随访1年,1年后复查冠状动脉造影,比较期间服药日比率和心血管事件发生率。结果:全程综合护理干预提高患者服药日比率(81.1±6.2%vs.60.9±5.9%,P<0.05),并减少患者心肌梗死及PCI术后再狭窄等心血管事件的发生(P<0.05)。结论:全程综合护理干预可提高心肌梗死患者遵医行为,降低二次心梗和冠状动脉再狭窄等心血管事件发生率,改善了患者的预后,为心梗患者的护理提供了新思路。

Objective： To evaluate the effect of a multi-factorial optimized holistic nursing on both medication adherence and cardiovascular events.Methods： Eligible coronary heart disease patients at age of 45-65 years were randomized to the intervention group（n=50） and control group（n=50）.The multi-factorial optimized holistic nursing was applied in intervention group,while the patients in control group received routine nursing.The primary outcome was medication adherence.Secondary outcomes included restenosis,cardiovascular events and stroke.Results： The proportion of days covered（PDC） in intervention group was significantly improved compared with control group（81.1±6.2% vs.60.9±5.9%,P0.05）.Moreover,the rates of restenosis and cardiovascular events were decreased in intervention group（P0.05）.However,there was no difference of the rates of stroke and cardiac death（P0.05）.Conclusion： A multi-factorial optimized holistic nursing can improve medication adherence,lower the rate of cardiovascular events,improve the prognosis of patients,and provides a new idea for the care of patients with myocardial infarction.