Application of whole-process home managementbased on WeChat in patients with coronary heart disease after stenting
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摘要:目的 探讨基于微信主导的全程居家管理在冠心病支架术后患者中的应用效果。方法 选择冠心病支架术后患者154例为研究对象，采用随机数字表法分为实验组78例和对照组76例。对照组给予常规出院指导、随访管理，实验组联合应用基于微信主导的全程居家管理。随访12个月，比较2组患者焦虑抑郁程度、自我管理能力、生活质量、主要心血管事件等指标。结果 随访12个月，实验验组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组，差异有统计学意义(P < 0.01)；实验组日常生活管理、疾病医学管理、情绪管理、自我管理能力总分高于对照组，差异有统计学意义(P < 0.05或P < 0.01)；实验组症状控制、心理社会功能、认知功能、治疗满意度、不良反应控制、生活质量评分高于对照组，差异有统计学意义(P < 0.01或P < 0.05)。实验组主要心血管事件发生率为7.69%，低于对照组的19.74%，差异有统计学意义(P < 0.05)。结论 基于微信主导的全程居家管理有助于缓解冠心病支架术后患者焦虑、抑郁程度，提高自我管理能力，改善其生活质量，预防主要心血管事件的发生。Abstract:Objective To explore the application effect of whole-process home management based on WeChat in patients with coronary heart disease after stenting.Methods A total of 154 patients with coronary heart disease after stenting were selected and divided into experimental group (n=78) and control group (n=76) by random number table method. The control group was given routine discharge guidance and follow-up management, while the experimental group was combined with whole-course home management based on WeChat. After 12 months of follow-up, anxiety and depression degree, self-management ability, quality of life, major cardiovascular events and other indicators of two groups were compared.Results After 12 months follow-up, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the experimental group were significantly lower than those in control group (P < 0.01); the total scores of daily life management, medical management of diseases, emotional management and self-management in the experimental group were significantly higher than those in the control group (P < 0.05 or P < 0.01); the scores of symptom control, psychosocial function, cognitive function, treatment satisfaction, adverse reaction control and quality of life in the experimental group were significantly higher than those in the control group (P < 0.01 or P < 0.05). The incidence of major cardiovascular events in the experimental group was 7.69%, which was significantly lower than 19.74% in the control group (P < 0.05).Conclusion The whole-course home management based on WeChat can alleviate the anxiety and depression of patients with coronaryheart disease after stenting, enhance self-management ability, improve their quality of life and prevent major cardiovascular events.
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Keywords:
- coronary heart disease /
- stent implantation /
- WeChat /
- home management /
- self-management ability /
- life quality
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表 1 2组干预前后SAS、SDS评分比较(x±s)
分 组别 n SAS SDS 出院时 随访12个月 出院时 随访12个月 实验组 78 41.36±6.45 27.63±4.12**## 38.12±7.10 28.24±4.36**## 对照组 76 40.42±5.72 33.45±5.16** 37.31±6.12 32.16±5.23** SAS: 焦虑自评量表; SDS: 抑郁自评量表。与出院时比较, **P＜0.01; 与对照组比较, ## P＜0.01。 
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表 2 2组干预前后自我管理能力评分比较(x±s)
分 指标 出院时 随访12个月 实验组(n=78) 对照组(n=76) 实验组(n=78) 对照组(n=76) 日常生活管理 26.24±4.32 27.02±4.16 32.45±5.12**# 30.36±4.65** 疾病医学管理 43.36±6.20 44.13±6.24 54.21±7.15**## 47.64±7.32* 情绪管理 10.32±1.24 10.45±1.15 13.56±2.32**## 12.03±2.24** 自我管理能力总分 79.92±10.32 81.90±9.56 100.22±13.24**## 90.03±12.45** 与出院时比较, * P＜0.05, **P＜0.01; 与对照组比较, #P＜0.05, ##P＜0.01。
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表 3 2组干预前后生活质量评分比较(x±s)
分 指标 出院时 随访12个月 实验组(n=78) 对照组(n=76) 实验组(n=78) 对照组(n=76) 症状控制 70.34±9.12 71.25±9.36 82.12±10.24**## 75.43±8.62* 躯体功能 67.45±8.24 69.16±9.20 76.36±8.45** 75.18±9.32** 心理社会功能 65.26±8.12 63.42±8.52 74.36±9.18**# 70.42±9.45** 认知功能 63.12±8.20 64.24±8.45 76.16±9.23**# 72.45±9.45** 治疗满意度 72.34±9.23 73.12±9.45 80.12±10.23**# 76.45±9.78* 不良反应控制 73.45±9.24 74.56±10.21 81.45±10.24**# 78.12±10.20* 生活质量 66.36±9.24 67.24±9.45 73.75±9.45**# 70.32±8.65* 与出院时比较, * P＜0.05, **P＜0.01; 与对照组比较, #P＜0.05, ##P＜0.01。
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表 4 2组主要心血管事件发生情况比较[n(%)]
组别 n 支架内再狭窄 不稳定心绞痛 急性心肌梗死 恶性心律失常 合计 实验组 78 1(1.28) 3(3.85) 1(1.28) 1(1.28) 6(7.69)* 对照组 76 3(3.95) 6(7.89) 4(5.26) 2(2.63) 15(19.74) 与对照组比较, * P＜0.05。
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