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目的观察加强健康宣教对提高心房颤动(房颤)患者抗凝治疗依从性的影响,提出有效的护理干预措施。方法 160例房颤并口服华法林抗凝治疗患者,随机分为常规宣教组和宣教加强组,各80例。常规宣教组采用传统常规护理,宣教加强组在此基础上给予综合护理干预。观察两组患者的国际标准t比值(INR)失访情况及服药依从性、停药及再出血发生情况。结果宣教加强组出院后1、3、6个月前往门诊复查INR失访率分别为0、1.25%、3.75%,与常规宣教组2.50%、5.00%、7.50%比较明显减少(P<0.05)。出院6个月后,宣教加强组服药依从性86.25%高于常规宣教组56.25%(P<0.05)。出院6个月后电话随访发现,宣教加强组停药发生率为2.50%,再出血发生率为1.25%,均低于常规宣教组的13.75%、7.50%(P<0.05)。结论对于房颤患者,加强健康宣教能够提高患者抗凝依从性,提高患者的认识,学会自我保健,在提高房颤患者INR达标率、降低栓塞风险上起到了重要的作用。
Objective To observe the effect of health education on improving the compliance of anticoagulant therapy in patients with atrial fibrillation (AF) and to propose effective nursing interventions. Methods 160 patients with atrial fibrillation and oral warfarin anticoagulant therapy were randomly divided into conventional mission group and mission-enhancing group, 80 cases each. Conventional mission group using the traditional routine care, mission to strengthen the group on the basis of comprehensive nursing intervention. Observed the two groups of patients with international standard t ratio (INR) loss of follow-up and medication compliance, withdrawal and rebleeding occurred. Results The rate of lost to INR at outpatients at 1, 3, and 6 months after discharge was 0. 1%, 3. 75% respectively, which was significantly lower than that of 2.50%, 5.00%, 7.50% of the conventional mission group (P 0.05) . Six months after discharge, the compliance of the mission-enhancing group was 86.25% higher than that of the conventional mission group (56.25%, P <0.05). Six months after discharge, follow-up by telephone showed that the incidence of remission in mission-boosting group was 2.50% and the rate of rebleeding was 1.25%, both of which were lower than 13.75% and 7.50% (P <0.05) of routine mission group. Conclusions For patients with atrial fibrillation, strengthening health education can improve anticoagulant compliance, improve patient awareness and learn self-care, which play an important role in improving INR compliance rate and reducing the risk of embolism in AF patients.