老年患者心脏机械瓣膜置换术后早期华法林抗凝治疗依从性及其影响因素

Compliance with early Warfarin anticoagulation therapy after mechanical valve replacement and its influencing factors in elderly patients

目的调查老年患者心脏机械瓣膜置换术(MHVR)后早期华法林抗凝治疗依从性及其影响因素。方法采用便利抽样法选取2017年1月至2019年10月期间在宁波市医疗中心李惠利医院心胸外科行心脏MHVR的老年患者210例进行前瞻性随访。调查时间为患者出院后6个月后,采用面对面问卷填写或电话随访的方式,调查患者的一般资料、华法林抗凝知识水平、抗凝治疗依从性现状及社会支持情况,分析影响老年患者MHVR后早期华法林抗凝治疗依从性的因素。结果老年患者MHVR后早期华法林抗凝治疗依从性总体水平较好,服药依从性好者占99.5%,国际标准化比值(INR)监测依从性好者占99.0%,均高于生活方式依从性好者92.1%。抗凝知识水平和年龄是影响患者依从性得分的主要因素。结论宁波地区老年患者MHVR后早期华法林抗凝治疗依从性较好,相关分析提示医护人员需加强对抗凝知识的宣教以及更加关注高龄老年人的抗凝依从性。

Objective To investigate the compliance with early Warfarin anticoagulation therapy after cardiac mechanical valve replacement(MHVR)and its related factors in elderly patients.Methods The convenience sampling method was used to prospectively recruit 210 patients undergone MHVR at the Ningbo Medical Center of Lihuili Hospital from January 2017 to October 2019.Six months after discharge,face-to-face interviews or telephone follow-ups were conducted to assess general information,warfarin anticoagulation knowledge,anticoagulant treatment compliance and social support.Results The overall compliance of early Warfarin anticoagulation therapy was excellent,with 99.5%of patients compliant with medication and 99.0%compliant with INR monitoring,both higher than the rate of compliance with advised lifestyle adjustment(92.1%).Anticoagulation knowledge and age were the main influencing factors for compliance in elderly patients after MHVR.Conclusions The compliance with early Warfarin anticoagulation therapy after MHVR is good in elderly patients in the Ningbo area.The correlation analysis suggests that medical professionals need to promote education on anticoagulation knowledge and pay more attention to anticoagulation compliance in elderly people.