心脏瓣膜置换术后患者华法林抗凝治疗和管理中PT/INR检测护理干预相关研究

Study on the Nursing Intervention of PT/INR in the Treatment and Management of Warfarin Anticoagulant After Heart Valve Replacement

目的探讨心脏瓣膜置换术后患者华法林抗凝治疗和管理中凝血酶原时间(PT/INR)检测护理干预相关临床研究结果。方法选取我院2013年1月—2015年12月心脏瓣膜置换术后患者60例为对照组,2016年1月—2017年5月同类手术患者60例为观察组。对照组患者术后采用传统健康教育等指导华法林抗凝治疗和管理干预措施,观察组在对照组基础上,增加PT/INR检测护理干预。对比两组患者出院时、出院后第1、3、6个月的PT/INR检测水平及患者抗凝知识和相关依从性问卷调查结果。结果观察组患者出院时、出院后第1、3、6个月复诊的PT/INR平均检测结果接近正常值水平者高于对照组,差异具有统计学意义(P<0.05);观察组患者出院时,出院后第1、3、6个月复诊时抗凝知识和相关依从性问卷调查得分均高于对照组,差异具有统计学意义(P<0.01)。结论心脏瓣膜置换术后患者华法林抗凝治疗和管理中PT/INR检测干预法,可使患者自觉、按时、定量服用抗凝药物华法林,抗凝治疗知识及自我管理意识增强,治疗相关依从性提高,保证了患者理想的华法林治疗窗。

Objective To explore the clinical results related to the intervention of prothrombin time （PT/INR） in the treatment and management of warfarin anticoagulant after heart valve replacement. Methods 60 patients after heart valve replacement in our hospital from January 2013 to December 2015 were selected as the control group. From January 2016 to May 2017, 60 patients of the same kind of surgery were selected as the observation group. The control group used the traditional health education to guide the Warfarin anticoagulant treatment and management intervention after the operation. On the basis of the control group, the observation group increased the PT/INR detection nursing intervention. The PT/INR test level of two groups of patients at discharge and the first, third, sixth months after discharge, and the results of the patient＇s knowledge of anticoagulant and related compliance questionnaire were compared. Results The PT/INR of the patients in the observation group at the time of discharge and frst, third, sixth months after discharge was closer to the normal level than those in the control group, and the difference was statistically significant （P 〈 0.05）. The scores of anticoagulation knowledge and related compliance in the observation group were higher than those in the control group at discharge time and frst, third, sixth months after discharge, and the difference was statistically signifcant （P 〈 0.01）. Conclusion PT/INR test intervention in the treatment and management of warfarin anticoagulant after heart valve replacement. Warfarin can be used consciously, regularly and quantitatively, and knowledge and self-management consciousness of anticoagulant therapy is enhanced, and the compliance of treatment is improved, which ensures ideal warfarin treatment window for patients.