张如玲+吴红英+王英

【摘要】目的研究多元化护理干预对心肌梗死患者治疗依从性及预后的影响。方法将100例心肌梗死患者按不同年份分为对照组及干预组，每组50例。2013年出院的患者为对照组，实施传统的常规护理，2014年出院的患者为干预组，开展多元化护理干预。出院随访1年，建立长期随访监督制度，指导患者利于健康的生活方式，比较干预期间坚持服药率和心血管事件发生率。结果干预组的护理干预提高了心肌梗死患者的治疗依从性，各种心脑血管事件的发生率均明显低于对照组，差异有统计学意义（P<0.05）。结论多元化护理干预可提高心肌梗死患者依从性，改善预后，为心梗患者的护理提供了新思路。

【关键词】心肌梗死；多元化护理干预；依从性；预后

中图分类号：R542.2+20.47文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.04.013

【Abstract】ObjectiveTo study the effect of the pluralistic nursing intervention on the compliance and prognosis of patients with myocardial infarction.MethodsAccording to different years，100 patients with acute myocardial infarction were divided into control group and intervention group，with 50 cases in each group.Patients who discharged in 2013 were selected as the control group，and they were given traditional routine care，and those discharged in 2014 as the intervention group，given pluralistic nursing intervention.All patients were followed up for 1 year，and long term follow-up supervision system was established to guide patients to develop a healthy lifestyle.In addition，medication adherence rate and incidence of cardiovascular events during intervention were compared between the two groups.ResultsIn the intervention group，nursing intervention increased treatment compliance，and the incidence of cardiovascular and cerebrovascular events was significantly lower than that of the control group，so difference was statistically significant（P<0.05）.ConclusionPluralistic intervention can improve treatment compliance of patients with myocardial infarction，and improve prognosis，which provides a new idea for the nursing care of the patients.

【Key words】myocardial infarction；pluralistic nursing interventions；compliance；prognosis

急性心肌梗死（AMI）是在冠狀动脉病变的基础上发生冠状动脉血供急剧减少或中断，使相应的心肌严重而持久地急性缺血坏死，病死率极高[1]。约50%以上的患者死于症状发作后1 h内[2]。目前我国心血管内科治疗AMI的主要方法有经皮冠状动脉球囊扩张术（PTCA）加冠状动脉内支架植入术（TCI）和榕栓治疗，药物治疗仍是心肌梗死出院后的重要手段。然而，多数患者对疾病认识不充分；病程较长，需要终身服药以及多药联合；经济因素等，导致患者服药依从性差，这是冠心病复发率及致死致残率持续增高的主要原因[3]。本研究对50例AMI患者实施多元化护理干预，提高了患者的依从性，使患者能坚持服药，定期复查，及时调整治疗方案，达到有效控制AMI的治疗效果，现将结果总结如下。

1对象与方法