冠心病PCI患者服药依从性与术后心血管事件的关系及护理对策研究

Research on relationship between medication compliance and postoperative cardiovascular events in PCI patients with coronary heart disease and its nursing strategies

目的:探讨冠心病冠状动脉介入治疗(PCI)患者术后服药依从性的影响因素及其与术后心血管事件发生的关系。方法:2015年1月~2016年1月对128例冠心病PCI患者用药依从性进行调查,应用Pearson单因素分析冠心病PCI患者用药依从性与术后心血管事件发生的关系,并制定干预措施。结果:128例冠心病PCI患者术后用药依从率为58.59%(75/128)。经单因素分析显示,年龄<60岁、学历高中或以上、月收入>3000元/月、就医方便、对药物知识了解、用药种类≤2种、家庭支持、接受过健康教育的患者用药依从性明显高于年龄≥60岁、学历初中或以下、月收入≤3000元/月、就医不方便、对药物知识不了解、用药种类>2种、家庭不支持及未接受过健康教育的患者。经logisitc多因素分析可知,年龄≥60岁、学历初中或以下、对药物知识不了解、用药种类>2种是影响冠心病PCI术后用药依从性的独立危险因素,而家庭支持、接受健康教育则是保护因素。与用药依次组相比,不依从组术后心血管事件发生率明显增加,两组比较有统计学意义(P<0.05)。结论:冠心病PCI患者术后服药依从性较低,且用药依从性差会增加患者术后心血管事件的发生。因此临床护理人员有必要对冠心病PCI服药依从性差的高危人群加强随访,以提高患者用药依从性,降低PCI术后心血管事件的发生。

Objective：To investigate the influencing factors of postoperative medication compliance in percutaneous coronary intervention （ PCI） patients with coronary heart disease and its relationship with postoperative cardiovascular events. Methods： A total of 128 PCI patients with coronary heart disease in our hospital from January 2015 to January 2016 were investigated regarding the medication compliance. The relationship between drug compliance and post-operative cardiovascular events was analyzed by Pearson univariate analysis. Intervention measures were established after the analysis. Results ： The follow -up rate of 128 PCI patients with coronary heart disease was 58. 59% （75/128）. Univariate analysis showed that medication compliance of patients with the age under 60 years old, degree of high school or above, monthly income which was above 3000 yuan, medical convenience, drug knowledge, drug type over 2 species, family support and health education was significantly higher than the patients with the age above 60 years old, degree of junior high school or below, monthly income less than 3000 yuan, medical inconvenience, do not understand the knowledge of drugs, drug types over 2 kinds, families do not support and have not received health education. Logisitc multi - factor analysis showed that factors such as the age over 60 years old, degree of junior high school or below, shortage of knowledge of drugs, drug types over 2 types were independent risk factors which influenced follow - up meditation compliance after PCI patients with coronary artery disease. Family support and health education were protection factors. Compared with the medication group, the inci-dence of cardiovascular events was significantly increased in the non - compliance group, and comparison between the two groups were statistically signifi-cant （ P 〈0.05）. Conclusion ： The compliance of PCI patients with coronary heart disease is low and the poor compliance of medication will increase the in-cidence of postoperative cardiovascular events. Therefore, clinical nurses need to strengthen follow - up of high - risk groups with coronary heart disease PCI medication compliance, thus improving patient compliance and reducing the incidence of cardiovascular events after PCI.