微信管理在冠心病PCI术后出院患者心脏康复护理中的应用

陈笑茜; 朱秀若; 张平妹; 姜文兵; 沈铖姬

doi:10.16766/j.cnki.issn.1674-4152.002527

微信管理在冠心病PCI术后出院患者心脏康复护理中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002527

1.
温州市人民医院心内科，浙江温州 325000
2.
树兰(杭州)医院心内科，浙江杭州 310000

基金项目:

浙江省教育厅科研项目 Y202045061

温州市科技局基础性医疗卫生科技项目 Y20180455

详细信息

通讯作者:
陈笑茜, E-mail: Tianzhang198738@163.com

中图分类号: R541.4 R473.54
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出版历程
- 收稿日期: 2021-01-15
- 网络出版日期: 2022-09-21

Application of WeChat management in cardiac rehabilitation nursing of discharged patients with coronary heart disease after PCI

1.
Department of Cardiology, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨微信管理在冠心病经皮冠状动脉介入治疗(PCI)术后出院患者心脏康复延续性护理中的效果。方法选取2017年10月—2018年3月在温州市人民医院心内科行PCI术的冠心病出院患者100例，按随机数字表法分为对照组和观察组，各50例。对照组给予常规出院宣教和手册，观察组除常规出院宣教和手册外，建立微信群，制定8周的康复计划。分别于患者出院后3个月和6个月评价比较2组患者生活质量评分、再就诊再住院率、心血管不良事件发生率及心血管危险因素达标情况。结果观察组出院后3个月、6个月生活质量评分分别(79.22±8.52)分、(79.42±7.80)分，优于对照组的(61.38±8.29)分、(62.74±11.45)分(均P < 0.05)；观察组患者出院后6个月内再就诊次数、再住院次数及胸痛不适发生次数均低于对照组，差异有统计学意义(均P < 0.05)；观察组患者出院后3个月内、6个月内心血管不良事件总发生率分别为6.0%和12.0%，均低于对照组的22.0%、42.0%(均P < 0.05)；观察组患者出院后6个月心血管危险因素血压、低密度脂蛋白胆固醇(LDL-C)、空腹血糖达标率分别为94.0%、92.0%、98.0%，均优于对照组的70.0%、66.0%、72.0%(均P＜0.05)。结论采取微信管理的延续护理方式能有效控制冠心病PCI术后出院患者的主要心血管危险因素，降低再就诊、再住院率，减少心血管不良事件的发生，提高生活质量，有利于改善患者预后。
- 微信管理 /
- 延续护理 /
- 冠心病 /
- 经皮冠状动脉介入治疗术后
Abstract: Objective To explore the effect of WeChat management in continuous nursing care of discharged patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods A total of 100 patients with coronary heart disease who underwent PCI in the Department of Cardiology of Wenzhou People's Hospital from October 2017 to March 2018 were selected. They were divided into the control group and observation group with 50 patients in each group according to the random number table method. The control group was given conventional discharge and manual, whereas the observation group established a WeChat group and made an 8-week rehabilitation plan in addition to routine discharge education and manual. The quality of life score, rehospitalisation rate, incidence of cardiovascular adverse events and compliance of cardiovascular risk factors were evaluated and compared between the two groups at 3 and 6 months after discharge. Results The quality of life scores of the observation group were (79.22±8.52) points and (79.42±7.80) points at 3 and 6 months after discharge, which were better than those of the control group [(61.38±8.29) points and (62.74±11.45) points, respectively, all P < 0.05]. The frequency of revisit and rehospitalisation and frequency of chest pain within 6 months after discharge in the observation group were all lower than those in the control group (all P < 0.05). The total incidence of adverse cardiovascular events in the observation group was 6.0% and 12.0% within 3 and 6 months after discharge, respectively, which were lower than those in the control group (22.0% and 42.0%, all P < 0.05). At 6 months after discharge, the compliance rates of cardiovascular risk factors such as blood pressure, LDL-C and fasting blood glucose in the observation group were 94.0%, 92.0% and 98.0%, respectively, which were better than those in the control group (70.0%, 66.0% and 72.0%, all P < 0.05). Conclusion The continuous nursing method of WeChat management can effectively control the main cardiovascular risk factors of patients discharged after PCI, reduce the rate of revisit and rehospitalisation, reduce the occurrence of cardiovascular adverse events, improve the quality of life and benefit the prognosis of patients.
- WeChat management /
- Continuing care /
- Coronary heart disease /
- After Percutaneous Coronary Intervention

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表 1 2组患者生活质量评分比较(x±s，分)

Table 1. Comparison of quality of life scores between two groups (x±s, scores)

组别	例数	生活质量评分			F值	P值
组别	例数	入院时	出院后3个月	出院后6个月	F值	P值
观察组	50	35.84±6.19	79.22±8.52^a	79.42±7.80^ab	718.867	＜0.001
对照组	50	34.88±6.42	61.38±8.29^a	62.74±11.45^ab	308.593	＜0.001
t值		0.761	10.612	8.514
P值		0.448	＜0.001	＜0.001
注：与入院时比较，^aP＜0.05；与出院后3个月比较，^bP＞0.05。

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表 2 2组患者再就诊和再住院、胸痛不适发生次数情况比较[M(P₂₅, P₇₅)]

Table 2. Comparison of the frequency of revisit and rehospitalization, chest pain and discomfort between the two groups [M(P₂₅, P₇₅)]

组别	例数	再就诊次数	再住院次数	胸部不适发生次数
观察组	50	0(0, 0)	0(0, 0)	0(0, 0)
对照组	50	0(0, 1)	0(0, 1)	1(0, 2)
Z值		-2.748	-3.546	-3.730
P值		0.006	＜0.001	＜0.001

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表 3 2组患者不良心血管事件发生情况比较[例(%)]

Table 3. Comparison of adverse cardiovascular events between two groups [case (%)]

组别	例数	出院后3个月内				出院后6个月内
组别	例数	心肌梗死	心力衰竭	心绞痛	总发生数	心肌梗死	心力衰竭	心绞痛	总发生数
观察组	50	2(4.0)	0	1(2.0)	3(6.0)	4(8.0)	1(2.0)	1(2.0)	6(12.0)
对照组	50	5(10.0)	2(4.0)	4(8.0)	11(22.0)	8(16.0)	6(12.0)	7(14.0)	21(42.0)
χ²值		0.614	0.510	0.842	5.316	1.515	2.458	3.397	11.416
P值		0.433	0.475	0.359	0.021	0.218	0.117	0.065	0.001

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表 4 2组患者心血管危险因素达标情况比较[例(%)]

Table 4. Comparison of cardiovascular risk factors in two groups [case (%)]

组别	例数	入院时			出院后3个月			出院后6个月
组别	例数	血压	LDL-C	空腹血糖	血压	LDL-C	空腹血糖	血压	LDL-C	空腹血糖
观察组	50	15(30.0)	28(56.0)	28(56.0)	44(88.0)	42(84.0)	46(92.0)	47(94.0)	46(92.0)	49(98.0)
对照组	50	19(38.0)	26(52.0)	24(48.0)	40(80.0)	37(74.0)	41(82.0)	35(70.0)	33(66.0)	36(72.0)
χ²值		0.713	0.161	0.641	1.190	1.507	2.210	9.756	10.187	13.255
P值		0.398	0.688	0.423	0.275	0.220	0.137	0.002	0.001	＜0.001

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