综合性康复干预对非瓣膜性房颤患者抗凝治疗依从性及生活质量的影响
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摘要
目的探讨综合性康复干预对非瓣膜性房颤(NVAF)患者抗凝治疗依从性及生活质量的影响。方法选取2015年1月～2017年1月期间就诊的NVAF患者共100例,随机分为观察组与对照组,两组患者均予以常规的药物治疗与健康指导,观察组患者在此治疗的基础上加用综合性康复干预,疗程6个月。观察两组患者抗凝治疗的依从性,并在干预前后检测两组的生活质量和疗效的差异。结果干预6个月后,两组患者治疗依从性Morisky评分均较干预前明显改善(P<0.05或P<0.01),且观察组改善幅度较对照组更显著(P<0.05);干预6个月后,两组生活质量SF-36评分均较干预前显著上升(P<0.05或P<0.01),且观察组上升幅度较对照组更显著(P<0.05)。结论综合性康复干预用于NVAF患者不仅能有效提高患者抗凝治疗的依从性,而且改善患者的生活质量。
Objective To investigate the effect of comprehensive rehabilitation intervention on anticoagulation therapy compliance and quality of life in patients with non-valvular atrial fibrillation(NVAF). Methods A total of 100 NVAF patients from January 2015 to January 2017 were randomly divided into observation group and control group. Both groups received routine medication and health guidance. Based on this treatment, the observation group was also given comprehensive rehabilitation intervention for 6 months. The compliance of anticoagulant therapy in the two groups was observed. And the quality of life and the difference in efficacy between the two groups was measured and compared before and after the intervention. Results After 6 months of intervention, the Morisky scores of the two groups were significantly improved compared with those before intervention(P<0.05 or P<0.01), and the improvement of the observation group was more obvious than that of the control group(P<0.05). After 6 months of intervention, the quality of life SF-36 scores of the two groups were significantly higher than those before treatment(P<0.05 or P<0.01), and the increase rate of the observation group was more significant than that of the control group(P<0.05). Conclusion Comprehensive rehabilitation intervention for NVAF patients can not only improve the compliance of patients with anticoagulant therapy,but also improve the quality of life of patients.
Objective To investigate the effect of comprehensive rehabilitation intervention on anticoagulation therapy compliance and quality of life in patients with non-valvular atrial fibrillation(NVAF). Methods A total of 100 NVAF patients from January 2015 to January 2017 were randomly divided into observation group and control group. Both groups received routine medication and health guidance. Based on this treatment, the observation group was also given comprehensive rehabilitation intervention for 6 months. The compliance of anticoagulant therapy in the two groups was observed. And the quality of life and the difference in efficacy between the two groups was measured and compared before and after the intervention. Results After 6 months of intervention, the Morisky scores of the two groups were significantly improved compared with those before intervention(P<0.05 or P<0.01), and the improvement of the observation group was more obvious than that of the control group(P<0.05). After 6 months of intervention, the quality of life SF-36 scores of the two groups were significantly higher than those before treatment(P<0.05 or P<0.01), and the increase rate of the observation group was more significant than that of the control group(P<0.05). Conclusion Comprehensive rehabilitation intervention for NVAF patients can not only improve the compliance of patients with anticoagulant therapy,but also improve the quality of life of patients.
引文
[1]陈文文,党和勤,耿涛,等.非瓣膜性房颤患者华法林用药依从性及其影响因素的调查研究[J].中国药房,2017,28(27):3763-3767.
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[10]何朝阳,张博然,李梅华.SF-36量表在肺结核病人中使用的信度和效度[J].中国公共卫生,2004,20(3):282-283.
[11]蒋周芩,舒茂琴,钟理,等.药物治疗与导管消融对心房颤动患者左心结构、功能及生活质量影响[J].中华心律失常学杂志,2014,18(4):175-279.
[12]曹文斋,张婷,钟德超,等.老年心房颤动患者社区管理方案[J].中国老年杂志,2017,37(5):1236-1238.
[13]郭阳,赵冬,孙佳艺,等.北京市非瓣膜病心房颤动患者血栓栓塞事件的发病风险及影响因素[J].心肺血管病杂志,2017,36(1):1-6.
[14]Wang ZZ,Du X,Wang W,et al.Long-term persistence of newly initiated warfarin therapy in Chinese patients with nonvalvular atrial fibrillation[J].Circ Cardiovasc Qual Outcomes,2016,9(4):380-387.
[15]杨劲松.利伐沙班与华法林预防心房颤动脑卒中安全性的对比[J].中国老年学杂志,2013,33(16):3988-3989.
[16]Faustino A,Providencia R,Barra S,et al.Which method of left atrium size quantification is the most accurate to recognize thromboembolic risk in patients with nonvalvular atrial fibrillation[J].Cardiovasc Ultrasound,2014,12(1):28.
[17]Huber K,Bates ER,Valgimigli M,et al.Antiplatelet and anticoagulation agents in acute coronary syndromes:What is the current status and what does the future hold?[J].Am Heart J,2014,168(5):611-621.
[18]Elewa H,Ahmed D,Barnes GD.Triple oral antithrombotic therapy in atrial fibrillation and coronary artery stenting:Searching for the best combination[J].Semin Thromb Hemost,2016,42(6):662-670.
[19]宋艳萍,徐华,孟光源.综合性干预措施提高医务人员手卫生依从性的研究[J].泰山医学院学报,2016,37(5):580-582.
[20]沈宏伟,马秀君.综合性干预对社区糖调节受损患者相关知信行的影响[J].中国初级卫生保健,2017,31(12):49-51.
[2]陈隽,洪华山,周一薇.非瓣膜性房颤抗凝治疗中华法林的应用研究[J].中国继续医学教育,2015,7(30):117-119.
[3]Saarinen JT,Rusanen H,Sillanpaan,et al.Impact of atrial fibrillation and inadequate antithrombotic management on mortality in acute neurovascular syndrome[J].J Stroke Cerebrovasc Dis,2014,23(9):2256-2264.
[4]杜晓明,陈闯,秦炎寒,等.非瓣膜性房颤患者华法林应用调查分析[J].中国药学杂志,2015,50(22):2000-2003.
[5]陶红,朱锐,吴校林,等.抑郁、焦虑症状对房颤患者健康相关生活质量影响的研究[J].现代医学,2015,43(7):888-890.
[6]戴萌,李滨,王忠明,等.抗栓治疗在低危和中危非瓣膜性房颤中的疗效分析[J].临床和实验学杂志,2015,14(12):111-114.
[7]黄从新,张澍,黄德嘉,等.心房颤动:目前的认识和治疗建议:2015[J].中国心脏起搏与心电生理杂志,2015,29(5):377-434.
[8]田国祥,张薇,武云涛,等.非瓣膜病性房颤抗凝治疗-华法林PK新型口抗凝药物[J].中国循征心血管医学杂志,2014,6(1):117-118.
[9]Morisky DE,Ang A,Krousel-Wood M,et al.Predictive validity of a medication adherence measure in an outpatient setting[J].J Clin Hypertens:Greenwich,2008,10(5):348-354.
[10]何朝阳,张博然,李梅华.SF-36量表在肺结核病人中使用的信度和效度[J].中国公共卫生,2004,20(3):282-283.
[11]蒋周芩,舒茂琴,钟理,等.药物治疗与导管消融对心房颤动患者左心结构、功能及生活质量影响[J].中华心律失常学杂志,2014,18(4):175-279.
[12]曹文斋,张婷,钟德超,等.老年心房颤动患者社区管理方案[J].中国老年杂志,2017,37(5):1236-1238.
[13]郭阳,赵冬,孙佳艺,等.北京市非瓣膜病心房颤动患者血栓栓塞事件的发病风险及影响因素[J].心肺血管病杂志,2017,36(1):1-6.
[14]Wang ZZ,Du X,Wang W,et al.Long-term persistence of newly initiated warfarin therapy in Chinese patients with nonvalvular atrial fibrillation[J].Circ Cardiovasc Qual Outcomes,2016,9(4):380-387.
[15]杨劲松.利伐沙班与华法林预防心房颤动脑卒中安全性的对比[J].中国老年学杂志,2013,33(16):3988-3989.
[16]Faustino A,Providencia R,Barra S,et al.Which method of left atrium size quantification is the most accurate to recognize thromboembolic risk in patients with nonvalvular atrial fibrillation[J].Cardiovasc Ultrasound,2014,12(1):28.
[17]Huber K,Bates ER,Valgimigli M,et al.Antiplatelet and anticoagulation agents in acute coronary syndromes:What is the current status and what does the future hold?[J].Am Heart J,2014,168(5):611-621.
[18]Elewa H,Ahmed D,Barnes GD.Triple oral antithrombotic therapy in atrial fibrillation and coronary artery stenting:Searching for the best combination[J].Semin Thromb Hemost,2016,42(6):662-670.
[19]宋艳萍,徐华,孟光源.综合性干预措施提高医务人员手卫生依从性的研究[J].泰山医学院学报,2016,37(5):580-582.
[20]沈宏伟,马秀君.综合性干预对社区糖调节受损患者相关知信行的影响[J].中国初级卫生保健,2017,31(12):49-51.