主动脉瓣重度狭窄患者经导管主动脉瓣膜置换术后生活质量现状及影响因素分析  

Quality of life and its influencing factors among severe aortic stenosis patients after transcatheter aortic valve replacement

作　　者：孟庆童 黄靖 李源 周春芬[3] 李旻露 方进博[1] Meng Qingtong;Huang Jing;Li Yuan;Zhou Chunfen;Li Minlu;Fang Jinbo(West China School of Nursing,Nursing Department,West China School of Medicine,Sichuan University,Chengdu 610041,China;Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Mental Health Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西护理学院(华西临床医学院护理系),成都610041 [2]四川大学华西医院骨科,成都610041 [3]四川大学华西医院心理卫生中心,成都610041

出　　处：《中华现代护理杂志》2019年第20期2535-2539,共5页Chinese Journal of Modern Nursing

基　　金：四川省软科学研究计划项目(2018SZ0194).

摘　　要：目的调查主动脉瓣重度狭窄(AS)患者经导管主动脉瓣置换(TAVR)术后生活质量,并分析其相关影响因素.方法通过医院电子病历系统,选取2012年4月—2017年4月在四川大学华西医院心血管内科接受TAVR手术的139例术后患者作为研究对象,采用患者一般情况调查表、查尔森基础疾病权重指数、Morisky服药依从性问卷和中国心血管病人生活质量评定问卷进行调查,并分析影响患者术后生活质量的因素.结果TAVR术后患者生活质量平均得分为(78.76±16.52)分,低于全国常模.不同年龄、婚姻、文化程度、术前心功能、查尔斯基础疾病权重、吸烟、饮酒和规律运动的患者生活质量得分存在统计学意义(P<0.05);逐步回归分析显示,年龄、婚姻、术前心功能、术后时间和规律运动可纳入回归模型,解释了34.9%的方差变异量.结论TAVR术后患者生活质量水平较低.年龄、婚姻、术前心功能、术后时间、规律运动会影响患者的生活质量.提示医务人员要重视TAVR患者术后生活质量,建议实施有针对性的护理干预,积极进行健康宣教,并实施科学的康复锻炼,改善患者术后生活质量.Objective To investigate the quality of life in patients with severe aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) and analyze the related influencing factors. Methods A total of 139 patients who had undergone TAVR in Department of Cardiovascular Medicine, West China Hospital, Sichuan University, were selected through the hospital electronic medical record system from April of 2012 to April of 2017. By using the General Information Questionnaire for Patients, Charlson's co-morbidity Index (CCI), Morisky Medication Adherence Scale, and China Cardiovascular Quality of Life Questionnaire (CQQC), their life quality were investigated and the influencing factors were analyzed. Results The average score of CQQC after TAVR was (78.76±16.52), lower than the national norm. There were statistical difference in the scores of CQQC in patients with different ages, marital status, educational background, cardiac function preoperation, CCI weight, smoking status, drinking status, and regular exercise status (P<0.05). Stepwise regression analysis indicated that, age, marital status, cardiac function preoperation, time of length postoperation and regular exercise could be included into the regression modal, accounting for 34.9% of variances. Conclusions The quality of life of patients after TAVR is low. Age, marital status, preoperative cardiac function, postoperative time and regular exercise will affect the quality of life of patients. It is suggested that medical staff should pay attention to the quality of life of TAVR patients after operation and carry out targeted nursing intervention and health education actively, as well as scientific rehabilitation exercise so as to improve the quality of life of TAVR patients after operation.

关 键 词：主动脉瓣狭窄 经导管主动脉瓣置换术 生活质量 影响因素 

分 类 号：R473.6[医药卫生—护理学]