综合护理干预对心脏瓣膜置换术后患者抗凝治疗依从性的影响

Influence of comprehensive nursing intervention on the compliance of anticoagulant therapy in patients undergone cardiac valve replacement

目的探讨综合护理干预对心脏瓣膜置换术后患者抗凝治疗依从性的影响。方法选择2012年2月至2015年2月在我院接受心脏机械瓣膜置换手术治疗的210例患者,以数字表法随机分为观察组和对照组各105例,观察组给予综合护理干预,对照组给予常规护理,比较两组患者术后对健康知识了解程度、抗凝治疗依从性以及药物不良反应情况。结果观察组患者对心脏瓣膜置换术(92.4%,97/105)以及抗凝知识的了解率[重要性97.1%(102/105)、危险因素90.5%(95/105)、预防知识94.3%(99/105)]均显著高于对照组[71.4%(75/105),74.3%(78/105)、69.5%(73/105)、74.3%(78/105)],差异均有显著统计学意义(P<0.01);观察组患者出血、血栓发生率分别为31.4%(33/105)与7.6%(8/105),均显著低于对照组的53.3%(56/105)和20.0%(21/105),抗凝治疗完全依从率为92.4%(97/105),显著高于对照组的69.5%(73/105),差异有显著统计学意义(P<0.01)。结论心脏瓣膜置换术后患者抗凝过程中,给予恰当的护理干预,能够有效提高患者对心脏瓣膜置换术相关知识以及抗凝治疗相关知识的了解,降低抗凝治疗过程中的出血及血栓发生率,提高患者抗凝治疗依从性。

Objective To discuss the clinical influence of comprehensive nursing intervention on the compliance of anticoagulant therapy in patients undergone cardiac valve replacement. Methods A total of 210 patients undergone cardiac valve replacement in our hospital from Feb. 2012 to Feb. 2015 were divided into the observation group(n=105) and the control group(n=105) according to random number table. The control group were given traditional nursing,and the observation group were given comprehensive nursing intervention. Then the knowledge of health, compliance of anticoagulant therapy and adverse drug reactions were compared between the two groups. Results The understanding rates of heart valve replacement(92.4%, 97/105) and knowledge of anticoagulation [importance 97.1%(102/105), risk factor 90.5%(95/105), prevention knowledge 94.3%(99/105)] in the observation group were significantly higher than those in the control group [71.4%(75/105), 74.3%(78/105), 69.5%(73/105), 74.3%(78/105), respectively, P<0.01). The incidences of hemorrhage and thrombosis in the observation group were 31.4%(33/105) and 7.6%(8/105), significantly lower than 53.3%(56/105) and 20.0%(21/105) in the control group(P<0.01). The complete compliance rate of anticoagulant therapy in the observation group was 92.4%(97/105), significantly higher than 69.5%(73/105) in the control group(P<0.01). Conclusion Comprehensive nursing intervention can effectively increase the understanding rate of heart valve replacement and knowledge of anticoagulation, reduce the incidence of hemorrhage and thrombosis, and improve the compliance rate of anticoagulant therapy in patients undergone cardiac valve replacement.