微信随访对心脏机械瓣膜置换术后患者抗凝效果及用药依从性的影响  

Effect of WeChat Follow-up on Anticoagulation Effect and Medication Compliance of Patients After Heart Mechanical Valve Replacement

作　　者：程欣欣[1] 黄惜珍[1] 林雁娟[1] CHENG Xinxin;HUANG Xizhen;LIN Yanjuan(Department of Cardiovascular Surgery,Fujian Medical University Union Hospital,Fuzhou Fujian 350000,China)

机构地区：[1]福建医科大学附属协和医院心血管外科,福建福州350000

出　　处：《中国卫生标准管理》2024年第14期181-184,共4页China Health Standard Management

摘　　要：目的探讨微信随访对心脏机械瓣膜置换术后农村患者的华法林抗凝效果及用药依从性的影响。方法选取2022年7月—2023年1月在福建医科大学附属协和医院进行心脏手术治疗的120例农村患者,并且进行为期6个月的随访。排除脱落患者,最终微信组纳入59例,电话组纳入54例。微信组创立了微信群,通过微信平台对患者推送相关信息;电话组通过专病随访平台定期向患者推送短信,并进行电话随访。通过用药依从性量表-8(Morisky medication adherence scale,MMAS-8)和华法林达标天数进行抗凝效果及用药依从性评估,同时观察2组不良事件。结果微信组华法林达标天数百分比为(77.3±8.1)%,高于电话组的(73.3±9.1)%,差异有统计学意义(P<0.05)。2组均未发生严重的出血和血栓事件。随访3个月时,电话组高依从性有5例,中依从性有18例,低依从性有31例;而微信组高依从性有7例,中依从性有32例,低依从性有20例,差异有统计学意义(P<0.05);在随访6个月时,电话组高依从性有7例,中依从性有22例,低依从性有25例;而微信组高依从性有11例,中依从性有34例,低依从性有14例,差异有统计学意义(P<0.05)。结论微信随访相较于电话随访可以更有效地提高华法林抗凝效果,且拥有良好的用药依从性。Objective To investigate the influence of WeChat follow-up on the anticoagulant effect and medication compliance of warfarin in rural patients after heart mechanical valve replacement.Methods A total of 120 rural patients who underwent cardiac surgery in Fujian Medical University Union Hospital from July 2022 to January 2023 were selected and followed up for 6 months.Excluding shedding patients,59 cases were included in the WeChat group and 54 in the telephone group.The WeChat Group created a wechat group to push relevant information to patients through the wechat platform;The telephone group regularly pushed SMS messages to patients through the specific disease follow-up platform,and conducted telephone follow-up.The anticoagulant effect and medication adherence were evaluated by Morisky medication adherence scale(MMAS-8)and the number of days of warfarin compliance,and adverse events in the two groups were observed.Results The percentage of warfarin compliance days in WeChat group was(77.3±8.1)%,higher than that in phone group(73.3±9.1)%,and the difference was statistically significant(P<0.05).No serious bleeding and thrombotic events occurred in both groups.At 3 months follow-up,there were 5 cases of high compliance,18 cases of medium compliance and 31 cases of low compliance in the telephone group.In the WeChat group,there were 7 cases of high compliance,32 cases of medium compliance,and 20 cases of low compliance,the difference was statistically significant(P<0.05).After 6 months of follow-up,7 cases of high compliance,22 cases of medium compliance and 25 cases of low compliance were found in the telephone group.In the WeChat group,there were 11 cases of high compliance,34 cases of medium compliance and 14 cases of low compliance,and the difference was statistically significant(P<0.05).Conclusion WeChat follow-up can improve the anticoagulant effect of warfarin more effectively than telephone follow-up,and has good medication compliance.

关 键 词：心脏机械瓣膜置换术 华法林 用药依从性 微信随访 电话随访 抗凝效果 

分 类 号：R473[医药卫生—护理学]