PCI术后冠心病患者4S管理2年随访研究

2-year Follow-up Study of 4S Management in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention

目的:探讨4S管理对PCI术后冠心病患者生存质量、生活习惯、用药依从性及预后的影响,本研究提出的4S管理的理念,即拯救患者(Salvation)、建立健康档案(Set up health records)、督促用药(Supervise)和加强心理健康教育(Strengthen sychological health education)。方法:将在我院经皮冠状动脉介入治疗(PCI)的126例患者,按随机分组设计分为4S管理组和对照组。其中4S管理组,对参与课题的心血管医护人员进行培训,同时对冠心病术后患者进行4S规范管理;另一组不进行医师培训和患者4S管理,作为对照组,对比两组患者的生存质量、生活习惯、用药依从性及预后。结果:4S管理组与对照组比较,4S管理组体质指数、血脂、心率、血压等指标均较好(P均<0.05),管理组患者日常生活行为方面得到改善(P均<0.05),两者在用药依从性方面,4S管理组(90.2%)明显优于对照组(55.8%,P=0.007),4S管理组患者的心源性死亡率(4.5%)较对照组低(8.4%,P=0.029)。结论:通过4S管理冠心病PCI术后患者,建立冠心病规范化完整的管理体系,深入患者群体中去,能够提高冠心病术后患者的生活质量,延长寿命。

Objective： To explore the effect of 4S management on the quality of life,living habits,medication compliance and prognosis of patients with coronary heart disease after percutaneous coronary intervention（ PCI）. The concept of 4S management proposed in this study is saving the patients,setting up health records,supervising urge medication and strengthening psychological health education. Methods： A hundred and twenty-six patients with PCI admitted in our hospital from July,2013 to July,2015 were randomly divided into 4S management group and control group. In the 4S management group,the cardiovascular health care personnel involved in the research were trained,and the patients with coronary heart disease were standardized management; the other group did not carry out the doctor training and the patient 4S management,The survival quality,living habits,medication compliance and prognosis of the two groups were compared.Results： Compared with the control group,the physical index,blood lipids,heart rate,blood pressure and other indicators were better in the 4S management group（ P〈0. 05）; the daily life behaviors of the patients in the management group were improved（ all P〈0. 05）; the management group（ 90. 2%） was significantly better than the control group（ 55. 8 %,P = 0. 007） in medication compliance. The cardiac death rate in the 4S management group（ 4. 5%） was lower than that in the control group（ 8. 4%,P = 0. 029）. Conclusion： The 4S management of managing patients with coronary heart disease after PCI,the establishment of standardized and complete management system of coronary heart disease,and going deep into the patient group can improve the quality of life and prolong the life span of the patients with coronary heart disease after surgery.