多学科协作随访模式在心房颤动患者射频消融术后空白期的应用

Application of multidisciplinary collaborative follow-up model in patients with atrial fibrillation in the blank period after radiofrequency ablation

目的探讨多学科协作随访在心房颤动(以下简称“房颤”)患者射频消融术后空白期的应用效果。方法纳入2018年1月—2020年5月于首都医科大学附属北京同仁医院心血管中心住院且首次行房颤射频消融术患者120例,采用随机数字表法将其分为两组,对照组60例患者采用常规随访模式;试验组60例患者采用多学科协作随访模式。两组均于出院后2周、1个月、2个月、3个月时进行随访。比较两组出院当天和随访3个月后房颤对生活质量的影响(AFEQT)量表各维度得分差值和其他观察指标(戒烟率、戒酒率、漏服药率、房颤复发率、超重患者体重指数的降低值、再住院率、出血事件发生率、健康自评)。结果随访3个月后,试验组AFEQT量表各维度得分差值、戒酒率、超重患者体重指数降低值均高于对照组,漏服药率低于对照组,健康自评优于对照组,差异均有统计学意义(均P<0.05)。两组戒烟率、房颤复发率、再住院率、出血事件发生率比较,差异无统计学意义(P>0.05)。结论多学科协作随访在饮酒、体重控制、服药管理及健康自评等方面均有效果,能够提高房颤患者术后空白期的生活质量,值得在临床护理工作中推广应用。

Objective To explore the application of multidisciplinary collaborative follow-up model in patients with atrial fibrillation in the blank period after radiofrequency ablation.Methods A total of 120 patients with radiofrequency ablation of atrial fibrillation for the first time admitted to the Cardiovascular Center of Beijing Tongren Hospital,Capital Medical University from January 2018 to May 2020 were enrolled.According to the random number table method,they were divided into two groups,the control group(60 cases)received routine follow-up model,and the experimental group(60 cases)received multidisciplinary collaborative follow-up model.Both groups were followed up at 2 weeks,1 month,2 months and 3 months after discharge.The differences in all dimensions scores of atrial fibrillation effect on quality-of-life(AFEQT)scale between the two groups on the day of discharge and three months after follow-up and other outcome indicators(smoking cessation rate,alcohol abstinence rate,drug omission rate,atrial fibrillation recurrence rate,body mass index difference of overweight patients,readmission rate,bleeding event rate,self-evaluation of health)were compared.Results After three months of follow-up,the differences in all dimensions scores of AFEQT scale,abstinence rate and body mass index difference of overweight patients in experimental group were higher than those in control group,drug omission rate was lower than that in control group,and the self-evaluation of health was better than that in control group,with statistical significance(all P<0.05).There were no significant differences in smoking cessation rate,atrial fibrillation recurrence rate,readmission rate and bleeding event rate between the two groups(P>0.05).Conclusion Multidisciplinary collaborative follow-up model is effective in alcohol consumption,weight control,medication management and self-evaluation of health,which can improve the quality of life of patients with atrial fibrillation in the postoperative blank period,and is worthy of promotion and application in clinical nursing work.