林雪坚 侯海娟 赖和平

【摘要】 目的：探讨对冠脉内支架植入（PCI）术后的冠心病合并高血压病患者进行延续性护理干预的可行性及其效果。方法：选取于本院接受PCI术的冠心病合并高血压患者200例，随机分为对照组及干预组，每组各100例，对照组行常规护理，干预组在对照组基础上行延续性护理干预，比较两组患者随访期间再住院次数，术后1年时服药依从性，血压、血脂水平，心绞痛控制情况及支架内再狭窄率等差异。结果：与对照组相比，干预组患者随访期间再住院次数较少，术后1年时服药依从性较好，血压、血脂达标率明显增高，心绞痛发作次数较少，支架内再狭窄发生率显著降低（P<0.05）。结论：对合并高血压病的冠心病PCI术后患者进行延续性护理干预，有利于增强患者的健康意识，提高服药依从性，更有效控制危险因素，减少心绞痛发作，降低支架内再狭窄率，提高生存质量，改善疾病预后。

【关键词】 延续性护理； 冠心病合并高血压病； PCI术后

【Abstract】 Objective：To discuss how continuous nursing apply to patients with coronary heart disease complicated with hypertension treated by PCI，and to observe the clinical effect.Method：A total of 200 patients who received the PCI in our hospital were selected as the research objects，they were randomly divided into intervention group and control group，100 cases in each group.The control group received the conventional nursing and intervention group received continuous nursing.The differences of medication adherence， re-hospitalization， the compliance rate of blood pressure and blood lipid and coronary in-stent restenosis of two groups were all observed for one year.Result：Compared with the control group，the patients in the intervention group had fewer times of hospitalization during the follow-up period，the compliance of the patients in the 1 year after operation was better，the blood pressure and blood lipid compliance rate increased significantly，the number of angina pectoris attacks was less，and the incidence of stent restenosis was significantly reduced，the differences were statistically significant （P<0.05）.Conclusion：Continuity of care markedly improve patients health consciousness and medication adherence，thus better prognosis can be achieved in patients of coronary heart disease complicated with hypertension undergoing PCI.

【Key words】 Continuity of care； Coronary heart disease complicated with hypertension； Percutaneous coronary intervention

First-authors address：Fuzhou First Hospital，Fuzhou 350009，China

doi：10.3969/j.issn.1674-4985.2018.04.023

隨着我国人口老龄化及城镇化进展，心血管病的患病率及死亡率逐年上升，据文献[1]显示，目前我国冠心病现患人数达1 100万，高血压病2.7亿，临床上高血压与冠心病往往合并存在。经皮冠脉支架植入（PCI）术是目前冠心病心绞痛的重要治疗方式之一，基于立竿见影的疗效，我国接受介入治疗的患者近些年呈平稳上升趋势，然而，文献[2]发现，PCI术后患者存在自我管理问题，服药依从性、医学面对状况等亦有差异，二级预防的薄弱影响了患者的生活质量及临床预后，本研究旨在探讨合并高血压的冠心病患者行PCI治疗后进行延续性护理干预的可行性及效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2014年5月-2016年5月期间就诊福州市第一医院心内科，诊断为冠心病合并高血压的患者共200例，冠心病及高血压病的诊断标准符合WHO规定。……