消化性溃疡患者医嘱依从性观察及对策

Observation of obeying medical orders and countermeasures

目的观察幽门螺杆菌阳性的消化性溃疡病人对医嘱的依从性状况,以及医嘱依从对疗效的影响。方法 观察512例病人,记录性别、年龄、职业、文化程度、溃疡类型、是否合并幽门螺杆菌感染以及治疗前后的症状变化,治疗结束1个月后复查胃镜、幽门螺杆菌情况,及其是否按医嘱要求服药、随访,不依从医嘱的原因。结果 消化性溃疡病人对医嘱的依从率为42.2％,主要原因有药费贵、交通不方便、遗忘等;医嘱依从性好者的溃疡愈合率、幽门螺杆菌根除率分别为96.3％、90.2％,而依从性差者仅为58.3％、51.7％,经X2检验,医嘱的依从性对疗效影响显著(P<0.O001)。结论提高患者对医嘱的依从性,以增加消化性溃疡及幽门螺杆菌阳性的根治率。

Objective To understand peptic ulcer patients obedience to medical orders and its influence on curative effects. Methods 512 patients were observed in terms of sex, age, occupation, education, types of ulcer, whether or not infection combined with helicobacter pylori (HP), and changes of symptoms before and after treatment, re-examination of HP under gastroscope 1 m after treatment, whether taking medication according to medical orders, fellow-up and reasons of not obedience of the medical orders. Results The obedience rate of peptic ulcer patients to medical orders was 42. 2%. Those patients with less education, unstable occupation, lack of intendance had poorer obedience, for the reasons of high cost of medication, inconvenience of communication and forgetfulness. The heal rate of ulcers and radical cure rate of HP between those with better obedience and those with poorer were 96. 3% and 58. 3%, 90. 2% and 51. 7% respectively. Obedience to medical orders had significant influence on the curative effects (P<0. 01). Conclusion In nursing, improvement of patient's obedience to medical orders is beneficial to the radical cure of HP in peptic ulcers.