基于医共体模式的抗凝管理对心房颤动患者抗凝管理知晓度及疾病控制的影响  

作　　者：刘福忠[1] 陆佳 董永超 陈波[1] 宋建江 杨叶秋 杨应军[1] 

机构地区：[1]浙江省嘉善县第一人民医院,314100

出　　处：《浙江临床医学》2024年第2期227-229,232,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020ZH056)。

摘　　要：目的探讨医共体模式下的抗凝管理对心房颤动患者抗凝知晓度及疾病控制的影响。方法选取2020年1月至2021年12月在本院接受治疗的房颤患者296例,采用随机数字表法分为对照组(148例)和观察组(148例)。对照组进行常规抗凝管理,观察组则采用医共体模式的抗凝管理,两组均管理6个月。统计两组疾病控制情况及不良事件发生情况,比较管理前和管理6个月后自我日常生活管理能力、抗凝管理知晓度及依从情况。结果管理期间,观察组因房颤发作反复就诊例次、心悸发作反复就诊例次、房颤再入院例次、国际标准化比值(INR)达标所需检查次数均低于对照组(P<0.05);管理6个月后,观察组抗凝达标率为79.73%,显著高于对照组(64.86%,P<0.05)。管理6个月后与管理前比较,两组房颤特异(栓塞)征象管理、影响INR因素管理、遵医行为管理、服用华法林管理、生活方式管理、不良嗜好管理评分均升高,观察组高于对照组(P<0.05)。管理6个月后,观察组抗凝管理知晓度及服药依从性、复诊依从性、合理饮食依从性评分高于对照组(P<0.05)。观察组总不良事件发生率为12.16%,显著低于对照组(25.68%,P<0.05)。结论基于医共体模式的房颤抗凝管理可有效改善患者疾病控制情况,提高其自我日常生活管理能力、抗凝管理知晓度及依从情况,降低不良事件的发生率。Objective To study the effect of anticoagulation management based on the medical community model on disease control and patient awareness in atrial fibrillation patients.Methods A total of 296 patients with atrial fibrillation admitted to our hospital from January 2020 to December 2021 were divided into the control group(148 cases)and the observation group(148 cases)by random number table method.The control group received conventional anticoagulant management,while the observation group received anticoagulation management based on the medical community model.Both groups were managed for 6 months.The disease control and adverse events of the two groups were counted,and the daily life management ability,awareness of anticoagulant management and compliance of anticoagulation management were compared before and after 6 months.Results During the management period,the number of repeated visits due to atrial fibrillation,palpitation,readmissions,and examinations required to reach the international normalized ratio(INR)standard in the observation group were lower than those in the control group(P<0.05).After 6 months of management,the compliance rate of anticoagulation in the observation group was significantly higher than that in the control group(79.73%VS.64.86%,P<0.05).The scores of specific atrial fibrillation signs management,INR factors management,compliance behavior management,warfarin administration,lifestyle management,and adverse habit management were higher in both groups than before management,and the observation group was higher than the control group(P<0.05).The awareness of anticoagulant management,medication compliance,return visit compliance,and reasonable diet compliance in the observation group were also higher than those in the control group(P<0.05).The incidence of total adverse events in the observation group was significantly lower than that in the control group(12.16%VS.25.68%,P<0.05).Conclusion Anticoagulation management based on the medical community model can effectively improve disease control

关 键 词：房颤 医共体模式 抗凝管理 抗凝管理知晓度 疾病控制 

分 类 号：R541.75[医药卫生—心血管疾病]