延续性健康管理对冠心病患者冠状动脉介入治疗术后的远期影响

Long-term effect of continued health management on patients with coronary artery disease after percutaneous coronary intervention

目的了解延续性健康管理对冠心病患者行冠状动脉介入治疗术后的远期影响。方法 2009年8月至2011年3月我院住院行经皮冠状动脉介入治疗(percutoneous coronary intervoution,PCI)的冠心病患者217例,采用随机数字表法分为试验组(105例)和对照组(112例)。对照组常规临床护理及健康教育,试验组行延续性健康管理,对患者生活方式进行干预,院外随访一年。结果试验组β受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)类药物使用率均高于对照组(P=0.001,0.016),戒烟率是对照组的1.62倍(OR=1.62,95%CI:1.22～2.15),高血压及糖尿病控制率均优于对照组(P=0.048,0.039),因冠心病一年再入院率低于对照组(P=0.02)。结论延续性健康管理可提高冠心病患者冠脉介入术后药物依从性、戒烟率,以及高血压和糖尿病控制率,降低冠状动脉介入治疗术后一年再入院率。

Objective To investigate the long-term effect of continued health management on patients with coronary artery dis- ease （CAD） after percutaneous coronary intervention （PCI）. Methods Two hundred and seventeen patients with coronary artery dis- ease after percutaneous coronary intervention enrolled between August 2009 and March 2011were randomly divided into intervention group （n = 105 ） and control group （n = 112）. The continued health management was performed in the intervention group. Results At one-year follow-up,the use rate of drug of ~3-blocker and ACEI or ARB was higher in the intervention group than that in the control group. The rate of smoking cessation was significant higher in the intervention group than that of the control group （ OR = 1.62,95 % CI ： 1.22-2. 15）. The control of blood pressure and blood glucose were more effectively in the intervention group than that in the control group （P = 0. 048 and 0. 039 ,respectively）. The rates of hospitalization for acute coronary syndrome （ACS） were 11.2% the in the intervention group compared to 23.8% in the control groups. Conclusions The Continued health management in patients with CAD af- ter PCI can improve the compliance of use of daily drug, the rate of smoking cessation, and the blood pressure and blood glucose control rates. It also reduces the rate of hospitalization for CAD.