抗凝团队在房颤患者围术期抗凝宣教中的作用和价值

Effect and Value of Anticoagulation Education and Research Group in the Education for Perioperative Patients with Atrial Fibrillation

目的:探讨抗凝团队对房颤患者围术期抗凝宣教的作用和价值。方法:对2017年1～6月就诊于上海交通大学医学院附属仁济医院的房颤患者,接受抗凝团队的围术期抗凝宣教,对宣教前后患者的抗凝知识进行问卷评分并对比,同时探讨不同年龄和学历对得分的影响。结果:本研究共纳入172名患者,其中包括行射频消融术患者142例,左心耳封堵术患者27例,射频消融术联合左心耳封堵术3例,选择达比加群酯116例,华法林53例,利伐沙班3例;根据患者服用的抗凝药物,抗凝团队进行抗凝宣教后,患者的抗凝知识问卷评分得到明显提高(P <0. 05);对于服用华法林患者,大专及以上学历宣教后得分显著高于初中及以下学历(P <0. 05),年龄≥75岁患者宣教后得分显著低于其他年龄层次(P <0. 05);对于服用新型口服抗凝药患者,大专及以上学历宣教前得分显著高于初中及以下学历(P <0. 05),年龄≥75岁患者宣教后得分显著低于年龄<60岁患者(P <0. 05)。结论:抗凝团队参与房颤患者围术期的抗凝宣教可提高其治疗的依从性。

Objective: To investigate the effect of anticoagulation education and research group in perioperative patients with atrial fibrillation. Methods: Anticoagulation education and research group performed education to atrial fibrillation patients admitted to Renji hospital from January to June 2017. The scores of anticoagulation knowledge questionnaires before and after the mission were compared,and the impact of different ages and degrees on which were explored. Results: A total of 172 patients were enrolled in the study including 142 patients undergoing AF ablation,27 patients undergoing left atrial appendage occlusion,3 patients undergoing AF ablation as well as left atrial appendage occlusion. Totally 116 patients were treated with dabigatran,53 patients were treated with warfarin and 3 patients were treated with rivaroxaban. The scores of anticoagulation knowledge questionnaires of patients were significantly improved after the anticoagulation education (P < 0. 05). For patients taking warfarin,the scores with junior college education or above were significantly higher than those with junior high school or below after education (P < 0. 05),and the scores of patients aged ≥75years were significantly lower than other age groups after education (P < 0. 05). For patients taking NOACs,the scores with junior college education or above were significantly higher than those with junior high school or below before education (P < 0. 05),and those aged ≥75 years were significantly lower than those aged < 60 years after education (P < 0. 05). Conclusion: Anticoagulation education and research group can improve the treatment compliance of perioperative patients with atrial fibrillation.