标题：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

      作者：曾碧茹，潘楚云，刘春燕，胡晓燕
    （深圳市人民医院留医部心血管外科，广东 深圳 518020）

      卷次： 2016年27卷3期

      【摘要】 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。

      【关键词】 护理干预；心脏瓣膜置换；抗凝治疗；依从性

      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2016）03—0511—03


Influence of comprehensive nursing intervention on the compliance of anticoagulant therapy in patients
undergone cardiac valve replacement.
ZENG Bi-ru, PAN Chu-yun, LIU Chun-yan, HU Xiao-yan. Department of
Cardiovascular Surgery, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, CHINA

【Abstract】 Objective To discuss the clinical influence of comprehensive nursing intervention on the compli-
ance of anticoagulant therapy in patients undergone cardiac valve replacement. Methods A total of 210 patients under-
gone 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 anticoag-
ulant 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.

      【Key words】 Nursing intervention; Cardiac valve replacement; Anticoagulant therapy; Compliance
·护 理·
6350.2016.03.063