临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
6期
89-92
,共4页
急性冠状动脉综合征%抗血小板治疗%依从性%影响因素
急性冠狀動脈綜閤徵%抗血小闆治療%依從性%影響因素
급성관상동맥종합정%항혈소판치료%의종성%영향인소
Acute coronary syndrome%Anti-platelet therapy%Compliance%Influential factor
目的探讨影响非血运重建急性冠状动脉综合征（ acute coronary syndrome,ACS)患者抗血小板治疗依从性的相关因素。方法选择我院2012年6月—2013年12月住院诊断为非ST段抬高急性冠状动脉综合征（ NSTE-ACS)且未行血运重建的130例,以按医嘱服药的时间、频次来评定患者治疗依从性。出院后3个月依据患者依从性高低分为完全依从组、部分依从组及不依从组3组,发放调查问卷,统计比较各组抗血小板治疗知识的知晓率,采用多因素logistic回归模型分析依从性的影响因素,评估恶性临床不良事件。结果随着出院时间（第1周~第3个月)的延长,130例非血运重建ACS患者抗血小板治疗依从性逐渐降低。完全依从组、部分依从组及不依从组抗血小板治疗知识的知晓率差异显著（P<0．01),完全依从组较另两组更高,差异有统计学意义（P<0．05,P<0．01)。多因素logis-tic回归模型分析显示文化程度、经济状况、家庭支持、护患关系及相关知识知晓程度是非血运重建ACS患者抗血小板治疗依从性的影响因素（P<0．05,P<0．01)。完全依从组再发心肌梗死、恶性心律失常、心源性休克发生率远低于部分依从组及不依从组,差异有统计学意义（P<0．05)。结论针对相关影响因素采取各种措施提高非血运重建ACS患者抗血小板治疗的依从性,可明显改善ACS疾病控制状况,提高康复率。
目的探討影響非血運重建急性冠狀動脈綜閤徵（ acute coronary syndrome,ACS)患者抗血小闆治療依從性的相關因素。方法選擇我院2012年6月—2013年12月住院診斷為非ST段抬高急性冠狀動脈綜閤徵（ NSTE-ACS)且未行血運重建的130例,以按醫囑服藥的時間、頻次來評定患者治療依從性。齣院後3箇月依據患者依從性高低分為完全依從組、部分依從組及不依從組3組,髮放調查問捲,統計比較各組抗血小闆治療知識的知曉率,採用多因素logistic迴歸模型分析依從性的影響因素,評估噁性臨床不良事件。結果隨著齣院時間（第1週~第3箇月)的延長,130例非血運重建ACS患者抗血小闆治療依從性逐漸降低。完全依從組、部分依從組及不依從組抗血小闆治療知識的知曉率差異顯著（P<0．01),完全依從組較另兩組更高,差異有統計學意義（P<0．05,P<0．01)。多因素logis-tic迴歸模型分析顯示文化程度、經濟狀況、傢庭支持、護患關繫及相關知識知曉程度是非血運重建ACS患者抗血小闆治療依從性的影響因素（P<0．05,P<0．01)。完全依從組再髮心肌梗死、噁性心律失常、心源性休剋髮生率遠低于部分依從組及不依從組,差異有統計學意義（P<0．05)。結論針對相關影響因素採取各種措施提高非血運重建ACS患者抗血小闆治療的依從性,可明顯改善ACS疾病控製狀況,提高康複率。
목적탐토영향비혈운중건급성관상동맥종합정（ acute coronary syndrome,ACS)환자항혈소판치료의종성적상관인소。방법선택아원2012년6월—2013년12월주원진단위비ST단태고급성관상동맥종합정（ NSTE-ACS)차미행혈운중건적130례,이안의촉복약적시간、빈차래평정환자치료의종성。출원후3개월의거환자의종성고저분위완전의종조、부분의종조급불의종조3조,발방조사문권,통계비교각조항혈소판치료지식적지효솔,채용다인소logistic회귀모형분석의종성적영향인소,평고악성림상불량사건。결과수착출원시간（제1주~제3개월)적연장,130례비혈운중건ACS환자항혈소판치료의종성축점강저。완전의종조、부분의종조급불의종조항혈소판치료지식적지효솔차이현저（P<0．01),완전의종조교령량조경고,차이유통계학의의（P<0．05,P<0．01)。다인소logis-tic회귀모형분석현시문화정도、경제상황、가정지지、호환관계급상관지식지효정도시비혈운중건ACS환자항혈소판치료의종성적영향인소（P<0．05,P<0．01)。완전의종조재발심기경사、악성심률실상、심원성휴극발생솔원저우부분의종조급불의종조,차이유통계학의의（P<0．05)。결론침대상관영향인소채취각충조시제고비혈운중건ACS환자항혈소판치료적의종성,가명현개선ACS질병공제상황,제고강복솔。
Objective To observe the compliance of acute coronary syndrome(ACS) patients without revasculariza-tion to anti-platelet therapy and its influential factors. Methods 130 patients with NSTE-ACS without recalculation therapy admitted to our hospital during June 2012 and December 2012 were evaluated on their compliance of anti-platelet therapy,and influential factors were analyzed statistically using questionnaires. Logistic regression analysis of factors was used and a clinical malignant event was assessed. Results As the discharge time ( week 1-3 months) extended, compliance of the 130 cases of without revascularization ACS patients anti-platelet therapy was reduced gradually. Knowledge awareness rate of anti-platelet therapy from full compliance group, partial compliance group and non-compliance group had significant difference (P<0. 01). Full compliance group was higher than the other two groups with statistically significant difference(P<0. 05, P<0. 01). The main influential factors included low antithrombotic knowledge, low income, family relations and nurse-patient relationship( P<0. 05,P<0. 01). In full compliance group, malignant clinical event rate was far lower than that of incomplete compliance group and noncompliance group, with statistically significant difference between the three groups (P<0. 05). Conclusion According to the risk factors, the antiplatelet therapy compliance can be enhanced for ACS patients without revascularization, using a varie-ty of measures, which can significantly improve disease control rate and increase recovery rate.
