风心病瓣膜置换术后疾病自我管理模式的建立及效果评价

Establishment and evaluation of self-management mode in patients with rheumatic heart disease after valve replacement

目的探讨疾病自我管理模式的建立对风湿性心脏病患者瓣膜置换术后的康复效果。方法将在我院因风湿性心脏病行瓣膜置换术患者38例随机分为实验组19例和对照组19例,对照组给予常规护理及健康指导,实验组在对照组基础上给予疾病自我管理培训;术后3个月比较两组心功能、生活质量和患者出院后遵医行为。结果术后3个月,实验组心功能Ⅰ级比例显著上升,Ⅱ级心功能比例明显降低,与对照组相比差异显著(P<0.05);实验组生存质量各项目得分显著高于对照组(P<0.01)。随访6个月,实验组按时复诊率、定期复查凝血酶原时间(PT)遵医次数显著高于对照组,按照PT值调整用药量频次显著低于对照组(P<0.01)。结论建立风湿性心脏病瓣膜置换术后患者疾病自我管理模式,能够提高患者心功能,改善患者生活质量,提高患者遵医行为,有利于患者康复。

Objective To explore the effects of establishment of self-management mode on the rehabilitation of patients with rheumatic heart disease after valve replacement. Total 38 patients with rheumatic heart disease to receive valve replacement in our hospital were randomly divided into experimental group and control group（n=19 per group）. The control group received routine nursing and health guidance, and on the basis of this, the experimental group received training in self-management of disease. After three months, cardiac function grade （CFG）, the quality of life of patients, and the medical compliance behavior of the patients after they left the hospital were compared between the two groups. Three months after the operation, the proportion of CFG-Ⅰaccording to New York Heart Association （NYHA） in the experimental group increased significantly and CFG-II decreased significantly, and there were significant differences from the control group （ ＆lt; 0.05）; the scores of quality of life in the experimental group were significantly higher than those in the control group （ ＆lt; 0.01）. After 6-month follow-up, the rate of timely return-visit and frequency of prothrombin （PT） reexamination in medical compliance in the experimental group were significantly higher than those in the control group, and the frequency of dosage adjustment according to the PT value was significantly lower than that in the control group （ ＆lt; 0.01）. Establishment of self-management mode in the patients with rheumatic heart disease after valve replacement can improve the CFG, the quality of life , and medical compliance of patients; it is conducive to the rehabilitation of patients.