上海华泾镇社区经皮冠状动脉介入术后患者康复治疗情况分析

Analysis of rehabilitation treatment of patients after percutaneous coronary intervention in Huajing Community,Shanghai

目的:通过调查社区经皮冠状动脉介入术(PCI)的术后患者康复和治疗情况,探讨全科医师对PCI术后患者管理的问题。方法:回顾性分析2019年8月至2021年12月上海市徐汇区华泾镇社区卫生服务中心门诊115例PCI术后患者临床资料,平均年龄(69±9.5)岁。通过面对面及电话随访询问患者体质量指数、伴随主要疾病、药物治疗、伴发高血压和糖尿病的血压和血糖控制、以及门诊健康宣教情况。结果:115例患者中,38.3%(44/115)的患者使用阿司匹林;48.7%(56/115)的患者使用他汀类药物,使用他汀类药物患者的LDL-C达标率为25.0%(14/56)。115例患者中有急性冠脉综合征(ACS)患者92例,其中合并高血压43例,血压达标率为83.7%(36/43),使用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体阻滞剂(ARB)、β受体阻滞剂降压药的37例,占86%(37/43);28.7%(33/115)患者伴有糖尿病,糖化血红蛋白<7%者占30.3%(10/33)。52.2%(60/115)的患者得到药物使用和注意事项的指导,12.2%(14/115)的患者得到合理运动、合理膳食和体重管理的指导。结论:全科医生在PCI术后康复治疗中存在着药物使用率低、危险因素控制率低、不重视非药物治疗等问题。

Objective:Through investigating rehabilitation and treatment of the patients after percutaneous coronary intervention(PCI)in the community,to discuss the management problems of patients after PCI by general practitioners.Methods:Retrospective analysis was made on the clinical data of 115 outpatients after PCI at the Community Health Service Center in Huajing Town,Xuhui District,Shanghai from August 2019 to December 2021,and their average was(69±9.5)years.Through face-to-face and telephone follow-up,patients were asked about body mass index,concomitant major diseases,drug treatment,the control of blood pressure and blood sugar,as well as the health education in the outpatient department for patients with hypertension and diabetes.Results:In 115,38.3%(44/115)patients used aspirin,48.7%(56/115)patients used statins and the reaching rate of LDL-C in patients using statins was not 25.0%(14/56).In 115,92 patients had acutecoronarysyndrome(ACS),43 patients were complicated with hypertension,and the rate of blood pressure reaching the standard was 83.7%(36/43),37 cases,accounting for 86%(37/43)used angiotensin converting enzyme inhibitor(ACEI)/angiotensinⅡreceptor blocker(ARB)βreceptor blockers antihypertensive agents;28.7%(33/115)patients had diabetes,and 30.3%(10/33)of them had glycosylated hemoglobin<7%.52.2%(60/115)patients received guidance on medication and precautions.12.2%(14/115)patients received guidance on proper exercises,diet and weight management.Conclusion:General practitioners have low drug use rate in rehabilitation treatment after PCI,the control rate of risk factors was low,and non-drug treatment was ignored.