基于家庭单元的延续性护理模式在老年心脏机械瓣置换患者华法林抗凝治疗中的应用

Effect of family unit-based continuous nursing model in warfarin anticoagulation among elderly patients with mechanical heart valve replacement

目的探讨基于家庭单元的延续性护理模式在老年心脏机械瓣膜置换(MHVR)患者术后长期华法林抗凝治疗中的应用效果。方法采用方便抽样法,选取2018年7月—2021年3月无锡市第二人民医院收治的MHVR术后接受长期华法林抗凝治疗的87例老年患者为研究对象,采用随机数字表法将患者分为观察组(n=46)和对照组(n=41)。对照组采取常规护理模式,观察组在此基础上采用基于家庭单元的延续性护理模式。比较两组患者治疗依从性、治疗有效性、治疗安全性3个层面的指标。结果治疗依从性方面,观察组患者的戒烟戒酒、饮食控制、遵医用药和定期复查4个维度达标率均优于对照组,差异有统计学意义(P<0.05)。治疗有效性方面,观察组国际标准化比值(INR)达标率和生活质量评分高于对照组,差异有统计学意义(P<0.05)。治疗安全性方面,两组患者出血事件发生率和血栓事件发生率比较差异均无统计学意义(P>0.05)。结论基于家庭单元的延续性护理模式具备有效性及安全性,可提高老年MHVR患者术后服用华法林治疗的依从性,提升老年患者的INR达标率和生活质量。

Objective To explore the effect of continuous nursing model based on family unit in long-term warfarin anticoagulation in elderly patients with mechanical heart valve replacement(MHVR).Methods From July 2018 to March 2021,87 elderly patients who underwent MHVR in Wuxi Second People's Hospital and received long-term warfarin anticoagulation after surgery were selected by convenience sampling as the research subject.The patients were divided into the observation group(n=46)and the control group(n=41)by random number table method.The control group adopted the routine nursing model,and the observation group adopted the family unit-based continuous nursing model on this basis.The two groups of patients were compared in terms of 3 indicators,namely treatment compliance,treatment effectiveness,and treatment safety.Results In terms of treatment compliance,the compliance rates of smoking and drinking cessation,diet control,compliance with medicines and regular review of patients in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).In terms of treatment effectiveness,the international normalized ratio(INR)compliance rate and the quality of life score of the observation group were higher than that of the control group with statistical differences(P<0.05).In terms of treatment safety,there was no significant difference in the incidence of bleeding events and thrombosis events between the two groups(P>0.05).Conclusions The continuous nursing model based on family unit is effective and safe,and can improve the compliance of elderly patients with MHVR taking warfarin after surgery,and improve the INR compliance rate and quality of life of elderly patients.