高龄冠心病患者PCI术后长期双联抗血小板的服药依从性与消化道出血的相关性

发布时间：2018-02-04 09:23

本文关键词： 经皮冠状动脉介入治疗服药依从性消化道出血　出处：《中国老年学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的探究老年经皮冠状动脉介入治疗(PCI)术后患者长期双联抗血小板的服药依从性与消化道出血的相关性。方法筛选进行PCI手术的老年患者300例,采用随机数字表法将其分为三组:A组(n=100)患者术后服用阿司匹林和氯吡格雷;B组(n=100)患者术后服用阿司匹林;C组(n=100)患者术后服用氯吡格雷。患者出院后的服药情况通过随访得到,随访时间为术后12个月。随访内容包括患者服药是否按照医嘱,若未按照医嘱,其停药时间和停药原因以及患者是否出现不良反应等情况。患者的消化道情况通过胃镜进行观察。结果 A组受试者中依从性好25例,一般17例,差58例;B组受试者中依从性好44例,一般40例,差16例;C组受试者中依从性好36例,一般50例,差14例。A组患者的服药依存性较差(P0.05)。此外,A组9例,B组4例,C组3例。A组患者的消化道出血比例较B、C组高(P0.05)。老年PCI术后患者服药依从性与患者年龄,付费方式呈负相关,与患者文化程度呈正相关,与患者性别没有相关性。结论老年PCI术后患者服药依从性越差,影响因素较多,应有针对性地做好相关工作。
[Abstract]:Objective to explore percutaneous coronary intervention (PCI) in elderly patients. The relationship between long-term anti-platelet compliance and gastrointestinal bleeding in patients after operation. Methods 300 elderly patients undergoing PCI operation were selected. The patients were randomly divided into three groups: group 1: group A took aspirin and clopidogrel; Group B (n = 100) took aspirin after operation; Patients in group C took clopidogrel after operation. The status of administration of clopidogrel after discharge was obtained by follow-up for 12 months. The follow-up included whether the drug was taken in accordance with the doctor's instructions. If not according to the doctor's order, the time of withdrawal, the reason of withdrawal and whether the patients had adverse reactions. The digestive tract of the patients were observed by gastroscopy. Results in group A, the compliance was good in 25 cases. General 17 cases, poor 58 cases; In group B, compliance was good in 44 cases, average in 40 cases and poor in 16 cases. In group C, compliance was good in 36 cases, average in 50 cases, poor in group A in 14 cases. In addition, there were 9 cases in group A and 4 cases in group B. The rate of gastrointestinal bleeding in group C was higher than that in group C (P 0.05). There was a negative correlation between drug compliance and age and payment method in elderly patients after PCI. Conclusion the worse the compliance of the elderly patients with PCI, the more influential factors are, and the better the related work should be done.
【作者单位】：贵航贵阳医院心内科;北京武警总医院心血管内科;
【分类号】：R541.4
【正文快照】： 1北京武警总医院心血管内科冠心病的致病原因十分复杂[1~9]。经皮冠状动脉介入治疗(PCI)是指经心导管技术疏通狭窄甚至闭塞的冠状动脉管腔,从而改善心肌的血流灌注的治疗方法,是临床中治疗急性心肌梗死的主要方法[10,11]。目前,临床中PCI介入路径包括股动脉路径和桡动脉路径两

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