不同护理方式对心脏机械瓣膜置换术后服用华法林患者的影响

Effect of Different Nursing Methods on Patients Taking Warfarin after Mechanical Heart Valve Replacement

目的:探讨延续性护理及常规护理方式对心脏机械瓣膜置换术后服用华法林患者的并发症发生率及抗凝治疗质量的影响。方法:将2020年1月至2020年12月在厦门大学附属心血管病医院治疗的72例心脏机械瓣膜置换术后服用华法林患者随机分为两组,各36例,对照组患者使用常规护理,观察组患者使用延续性护理,比较两组患者的并发症发生率、抗凝治疗质量、治疗依从性、生活质量。结果:观察组患者出血并发症及血栓并发症总发生率均低于对照组,差异具有统计学意义(P<0.05);观察组患者抗凝效果良好的人数占比高于对照组,抗凝效果一般、较差的人数占比低于对照组,差异具有统计学意义(P<0.05);观察组患者规律用药、合理饮食、定期复查的抗凝治疗依从性均高于对照组,差异具有统计学意义(P<0.05);观察组患者躯体功能、社会功能、物质生活状态、心理功能评分均高于对照组,差异具有统计学意义(P<0.05)。结论:对心脏机械瓣膜置换术后服用华法林的患者使用延续性护理,能有效提高患者抗凝治疗质量和治疗依从性,降低其并发症发生率,改善生活质量。

Objective To investigate the effects of continuous nursing and routine nursing on the incidence of complications and the quality of anticoagulant therapy in patients taking warfarin after mechanical heart valve replacement.Methods A total of 72 patients treated with warfarin after mechanical heart valve replacement in Xiamen Cardiovascular Hospital Xiamen University from January 2020 to December 2020 were randomly divided into two groups,with 36 cases in each group.The control group used routine nursing,and the observation group used continuity of care.The complication rate,anticoagulant treatment quality,treatment compliance,quality of life of the two groups of patients were compared.Results The total incidence of bleeding complications and thrombosis complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The proportion of people with good anticoagulant effect in the observation group was higher than that in the control group,and the proportion of people with average and poor anticoagulant effect was lower than that in the control group,the differences were statistically significant(P<0.05).The compliance of the observation group with regular medication,reasonable diet and regular review of anticoagulant therapy were higher than those of the control group,the differences were statistically significant(P<0.05).The scores of physical function,social function,material life status and psychological function in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Continuity of care for patients taking warfarin after mechanical heart valve replacement can effectively improve the quality of anticoagulant therapy and treatment compliance,reduce the incidence of complications,and improve the quality of life.