延续护理在经皮腔内冠状动脉成形术后病人二级预防中的应用研究

Study on application of continuity of care in secondary prevention for patients after percutaneous coronary intervention

[目的]探讨延续护理对经皮腔内冠状动脉成形术(PCI)术后病人二级预防的影响。[方法]选择2012年8月—2013年5月实施PCI手术病人200例作为研究对象,采用分段随机分组,试验组和对照组各100例,两组病人均接受PCI手术常规治疗、护理与出院指导,随访1年,试验组在此基础上实施延续护理。比较两组病人1年后治疗依从性、冠心病事件发生率及血压、血糖、血脂达标率。[结果]1年后,试验组病人治疗依从性评分为:服药依从性(3.63±0.93)分,改善生活方式依从性(2.75±0.84)分,控制体重依从性(0.54±0.50)分,定期复诊依从性(0.79±0.41)分,均明显高于对照组(3.21分±1.25分,2.48分±1.05分,0.44分±0.50分,0.65分±0.48分),差异有统计学意义(P<0.05或P<0.01);且试验组1年后血压、血糖、血脂达标率分别为77.4%、91.4%、83.9%,高于对照组(63.5%、76.5%、58.8%),冠心病事件发生率为15.1%,低于对照组(29.4%),差异有统计学意义(P<0.05或P<0.01)。[结论]延续护理能促进PCI术后二级预防措施的落实,改善病人治疗依从性,提高血压、血糖、血脂达标率,降低冠心病事件发生率。

Objective：To probe into the influence of continuity of care on secondary prevention for patients after percutaneous coronary intervention.Methods：A total of 200 patients who received the PCI from August 2012 to May 2013 were selected as the research objects,they were randomly divided into experimental group and control group,100 cases in each.All of them received the conventional treatment,nursing and discharge instruction of PCI,and they were followed up for one year.While the patients in experimental group also received the continui-ty of care,then to compare the treatment compliance,the incidence of coronary heart disease events and the compliance rate of blood pressure,blood glucose and blood lipid of patients in two groups after one year.Re-sults：After one year,in experimental group the treatment complicance scores：the medication compliance score was（3.63±0.93）,the improving lifestyle compliance score was（2.75 ±0.84）,the weight control compliance score was（0.54±0.50）,and the regular consultation compliance score was（0.79±0.41）.The treatment compli-ance scores in experimental group were higher than those in control group（3.21±1.25,2.48±1.05,0.44±0.50, 0.65±0.48）,and the differences were statistically significant（P 〈0.05 or P 〈0.01 ）.The compliance rate of blood pressure,blood glucose and blood lipid of patients in experimental group after one year respectively were 77.4%,91.4% and 83.9%,which were higher than those in control group （63.5%,76.5%,58.8%）.The inci-dence of coronary heart disease events was 15.1%,which was lower than that in control group（29.4%）,and the difference was statistically significant（P 〈0.05 or P 〈0.01）.Conclusion：The continuity of care can promote the implementation of secondary prevention after PCI,improve the patients＇treatment compliance,and improve the compliance rate of blood pressure,blood glucose,blood lipid and reduce the incidence of coronary heart disease events.