综合护理干预对心脏机械瓣膜置换术后患者服药依从性及生活质量的影响

Effects of comprehensive nursing intervention on medication compliance and quality of life in patients after heart mechanical valve replacement

目的探讨综合护理干预对心脏机械瓣膜置换术后患者服药依从性及生活质量的影响。方法收集行心脏机械瓣膜置换术的60例患者,根据随机数字表法分为对照组和观察组,每组30例。观察组实施综合护理干预,对照组给予常规护理。观察并随访采用两种不同护理措施患者的服药依从性、抗凝药物不良反应发生率、患者术后生存质量及患者对瓣膜置换术的了解程度等指标。结果观察组患者术后6个月服药依从性为90%显著高于对照组的50%,术后2年的服药依从性高于对照组患者,差异有统计学意义(P<0.05);观察组患者术后6个月和术后2年生存质量的各项内容(心理、独立性、社会关系、环境、生理)评分均明显高于对照组;观察组患者对瓣膜置换术及术后抗凝药物服用的重要性的知晓率(100%)明显高于对照组(86.7%);观察组术后6个月及术后2年服用抗凝药物的不良反应发生率却明显低于对照组。差异有统计学意义(P<0.05)。结论心脏机械瓣膜置换术后给予患者综合性护理干预,可以增强患者对瓣膜置换术及术后服用抗凝药物的必要性的认识,主动坚持服药,有效减少服用抗凝药物后的不良反应发生,提高患者的生存质量。

Objective To observe the effects of comprehensive nursing intervention on medication compliance and quality of life in patients after heart mechanical valve replacement.Methods Sixty patients who underwent heart mechanical valve replacement in our hospital from March 2015 to February 2016 were enrolled in the study.According to random digital table method,these patients were divided into control group(n=30)and observation group(n=30).The patients in observation group were treated by comprehensive nursing interventions,however,the patients in control group were treated by routine care.The medication compliance,incidence rate of adverse reactions of anticoagulant drugs,postoperative life quality and patient’s understanding degree to valve replacement were observed and compared between the two grousp.Results The medication compliance rates at 6 months and 2 years after surgery in observation group were significantly higher than those in the control group(P<0.05).Moreover the postoperative life quality scores at 6 months and 2 years after surgery in observation group were superior to those in control group(P<0.05).In addition the awareness rate of the importance of valve replacement and postoperative anticoagulant use in observation group was significantly higher than that in control group(P<0.05),however,the incidence rate of adverse reactions of anticoagulant drugs at 6 months and 2 years after surgery in observation group was significantly higher than that in control group(P<0.05).Conclusion The comprehensive nursing intervention for patients after heart valve replacement can strengthen the patient’s understanding degree to the need for heart valve replacement and postoperative anticoagulant drugs application,it is neccesary for patients to take drugs initiatively,which can effectively reduce the occurrence of adverse reactions after taking anticoagulant drugs so as to improve the life quality of patients.