康復路徑教育在冠心病介入治療患者心臟康復中的臨床效果觀察

周波+朱糧+劉紅臻

【摘要】 目的 討論康復路徑教育在冠心病介入治療患者心臟康復中的療效。方法 70例冠心病患者， 隨機分為觀察組和對照組， 每組35例。兩組患者均予介入治療、藥物治療結合的方式， 對照組予常規教育， 觀察組在對照組的基礎上予康復路徑教育。術后隨訪1年， 觀察兩組患者冠心病康復知識、自我管理、自我效能以及危險因素控制情況。結果 干預前， 兩組患者的康復知識、自我管理、自我效能、血壓達標率、吸煙率及LDL-C水平比較差異無統計學意義（P>0.05）。干預后， 兩組患者的康復知識、自我管理、自我效能、血壓達標率、吸煙率及LDL-C水平均明顯高于干預前， 差異具有統計學意義（P<0.05）。干預后， 觀察組患者的康復知識（81.69±6.93）分、自我管理（110.52±16.78）分、自我效能（31.98±6.59）分、吸煙率8.57%、血壓達標率88.57%及LDL-C（2.03±1.15）mmol/L均明顯優于對照組的（74.49±5.89）分、（90.74±21.56）分、（26.41±7.58）分、28.57%、60.00%、（2.71±1.59）mmol/L， 差異具有統計學意義（P<0.05）。結論 冠心病介入術后予康復路徑教育可以提高患者的冠心病康復知識、自我管理、自我效能管理、危險因素控制情況， 在臨床上可廣泛使用。

【關鍵詞】 康復路徑教育；冠心病介入；康復；效果

DOI：10.14163/j.cnki.11-5547/r.2018.02.075

Observation on clinical effect of rehabilitation pathway education on cardiac rehabilitation in coronary heart disease patients with interventional therapy ZHOU Bo， ZHU Liang， LIU Hong-zhen. Department of Internal Medicine-Cardiovascular， Qingdao Eighth Peoples Hospital， Qingdao 266100， China

【Abstract】 Objective To discuss the efficacy of rehabilitation pathway education on cardiac rehabilitation in coronary heart disease patients with interventional therapy. Methods A total of 70 coronary heart disease patients were randomly divided into observation group and control group， with 35 cases in each group. Both groups received interventional therapy and drug treatment， and the control group received conventional education. The observation group received rehabilitation pathway education on the basis of the control group. After 1 years of follow-up， the rehabilitation knowledge of coronary heart disease， self-management， self-efficacy and control of risk factors were observed in the two groups. Results Before intervention， both groups had no statistically significant difference in rehabilitation knowledge， self-management， self-efficacy and control of risk factors （P>0.05）. After intervention， both groups had obviously higher rehabilitation knowledge， self-management， self-efficacy， blood pressure standard rate， smoking rate and low density lipoprotein cholesterol （LDL-C） level than before intervention， and their difference was statistically significant （P<0.05）. After intervention， the observation group had rehabilitation knowledge as （81.69±6.93） points， self-management as （110.52±

16.78） points， self-efficacy as （31.98±6.59） points， smoking rate as 8.57%， blood pressure standard rate as 88.57% and LDL-C as （2.03±1.15） mmol/L， which were all obviously better than （74.49±5.89） points， （90.74±21.56） points， （26.41±7.58） points， 28.57%， 60.00% and （2.71±1.59） mmol/L in the control group， and their difference was statistically significant （P<0.05）. Conclusion Rehabilitation education after coronary artery intervention can improve rehabilitation knowledge， self-management， self-efficacy management and control of risk factors of coronary heart disease patients， and it can be widely used in clinic.endprint

【Key words】 Rehabilitation pathway education； Coronary heart disease intervention； Rehabilitation； Effect

冠心病是指冠狀動脈發生動脈粥樣硬化病變導致血管狹窄或者阻塞， 引起心肌缺血、缺氧或者壞死從而引起心臟病[1]。近年冠心病患者人數逐漸增多， 而且發病趨于年輕化， 在治療時均予介入治療、藥物治療結合的方式。經皮冠狀動脈介入治療（PCI）是應用帶氣囊導管經外周動脈送到冠狀動脈狹窄處， 充盈氣囊可使狹窄處的官腔擴張， 并在狹窄處放置支架， 改善血流， 術后可應用藥物控制不良反應的發生[2]。PCI創傷小、恢復快、療效好， 應用較廣泛， 但是手術并沒有改變冠狀動脈粥樣硬化的進程， 需要術后長期進行康復[3]， 現討論康復路徑教育在冠心病介入治療患者心臟康復中的療效。

1 資料與方法

1. 1 一般資料 選擇2016年3月～2017年3月在本院經介入治療的冠心病患者70例， 隨機分為觀察組和對照組， 各