标题：5A模式对心脏瓣膜置换术后患者抗凝治疗依从性的影响

      作者：李清月，许晨耘，阮淑妹    海南省人民医院心脏外科，海南 海口 570311

      卷次： 2019年30卷5期

      【摘要】 目的 探究 5A模式对心脏瓣膜置换术后患者抗凝治疗依从性的影响。方法 选取 2016年 1月至2018年1月期间海南省人民医院心脏外科收治的176例心脏瓣膜置换术后患者为研究对象，依据随机数表法将患者分为对照组和观察组，每组88例。对照组患者给予术后常规护理，观察组在常规护理的基础上联合5A模式护理。比较两组患者干预前、干预后对抗凝知识的掌握情况和对抗凝治疗的依从性(包括按时服药、定期复查、饮食调理、自我检测情况)，并比较因抗凝不当引起的并发症发生情况。结果 干预前，两组患者对抗凝知识的掌握情况、按时服药、定期复查、饮食调理、自我检测评分比较，差异均无统计学意义(P>0.05)；干预后，两组患者对抗凝知识掌握情况、按时服药、定期复查、饮食调理、自我检测评分均较干预前显著改善，且观察组优于对照组，差异均具有统计学意义(P<0.05)；观察组患者因抗凝不当引起的并发症总发生率为6.80%，明显低于对照组的22.68%，差异具有统计学意义(P<0.05)。结论 心脏瓣膜置换术后患者经5A模式护理干预后能够有效改善其对抗凝知识的掌握情况，提高抗凝治疗依从性，降低因抗凝不当引起的并发症发生率，5A模式护理可在临床中进一步推广和改善。
      【关键词】 心脏瓣膜置换术；5A模式；抗凝治疗；依从性；并发症
      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2019）05—671—04E

ffect of 5A mode on compliance of anticoagulation therapy in patients after cardiac valve replacement.
LIQing-yue, XU Chen-yun, RUAN Shu-mei, Department of Cardiac Surgery, Hainan General Hospital, Haikou 570311,Hainan, CHINA
【Abstract】 Objective To investigate the effect of 5A mode on the compliance of anticoagulation therapy in pa-tients after cardiac valve replacement. Methods A total of 176 patients undergoing cardiac valve replacement fromJanuary 2016 to January 2018 were enrolled in the study, which were divided into control group (n=88) and observationgroup (n=88) according to random number table. The control group received routine postoperative care, and the observa-tion group received 5A mode care based on routine postoperative care. The mastery of anticoagulation knowledge beforeand after the intervention was compared between the two groups. The status of on-time medication, regular review, dietconditioning, and self-testing were scored, and the complications caused by improper anticoagulation were compared.Results There was no significant difference in the mastery of anticoagulant knowledge, on-time medication, regular re-view, dietary conditioning, and self-testing scores between the two groups before intervention (P>0.05). Before interven-tion, the mastery of anticoagulant knowledge, on-time medication, regular review, dietary conditioning, and self-testingscores were significantly improved, and the values in the observation group were superior to those in the control group(P<0.05). The total incidence of complications caused by improper anticoagulation was 6.80% in the observation group,significantly lower than 22.68% in the control group (P<0.05). Conclusion 5A mode of nursing intervention can effec-tively improve their mastery of anticoagulant knowledge in patients with heart valve replacement, improve anticoagulanttreatment compliance, and reduce the incidence of complications caused by improper anticoagulation, which worth fur-ther promotion and improvement.
      【Key words】 Heart valve replacement; 5A mode; Anticoagulant therapy; Compliance; Complication·护理·doi:10.3969/j.issn.1003-6350.2019.05.037