基于ABC路径的信息化整体护理在房颤患者管理中的应用效果

摘要/Abstract

摘要： 目的在移动健康软件的支持下,探索基于ABC路径的整体护理在房颤患者中的临床应用效果。方法回顾性收集2019年7月~2020年12月在首都医科大学附属北京潞河医院住院接受常规护理的58例患者临床资料作为对照组,将2021年2月~2021年12月接受基于ABC路径的整体护理的38例患者作为试验组。对两组患者进行一年的随访研究,比较两组患者1年后卒中、出血事件、再住院的例数以及治疗窗内时间、症状控制的情况。结果试验组患者的抗凝质量以及心率或节律症状控制方面要高于对照组,差异有统计学意义（P<0.05）;两组在观察期间卒中发生例数、中重度出血事件以及再住院例数方面比较,差异无统计学意义（P>0.05）。结论基于ABC路径的信息化整体护理在房颤患者管理中有良好的临床应用效果。

关键词: 心房颤动, ABC路径, 整体护理, 信息化

中图分类号:

R541.7

叶蕊, 郑志涛, 孙婷婷. 基于ABC路径的信息化整体护理在房颤患者管理中的应用效果[J]. 中华养生保健, 2023, 41(2): 81-84.

参考文献

[1] Brieger D, Amerena J, Attia J, et al.National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the diagnosis and management of atrial fibrillation 2018[J]. Heart Lung Circ, 2018,27(10):1209-1266.
[2] Kirchhof P, Benussi S, Kotecha D, et al.2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J]. Europace, 2016,18(11):1609-1678.
[3] Lip G Y H, Banerjee A, Boriani G, et al. Antithrombotic therapy for atrial fibrillation: CHEST guideline and expert panelreport[J]. Chest,2018, 154(5):1121-201.
[4] Lane D A, Lip G Y H. Integrated care for the management of atrial fibrillation: what are the key components and important outcomes?[J].Europace, 2019,21(12):1759-1761.
[5] Paulus K.The future of atrial fibrillation management: integrated care and stratified therapy[J]. Lancet, 2017,390:1873-1887.
[6] Lip G Y H. The ABC pathway: an integrated approach to improve AF management[J]. Nat Rev Cardiol, 2017,14(11):627-628.
[7] 蒋晨阳,王云鹤.2014AHA/ACC/HRS房颤管理指南解读[J].中国医刊,2015,50(10):30-34.
[8] 顾敏. 远程医疗应用于心房颤动华法林抗凝管理的研究[D].扬州:扬州大学,2019.
[9] Schnabel R B, Yin X, Gona P, et al.50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study[J]. Lancet, 2015, 386(9989): 154-62.
[10] Fihn S D, McDonell M, Martin D, et al. Risk factors for complications of chronic anticoagulation. A multicenter study. Warfarin Optimized Outpatient Follow-up Study Group[J]. Ann Intern Med, 1993,18(1):511-20.
[11] 中华医学会心血管病学分会,中国老年学学会心脑血管病专业委员会.华法林抗凝治疗的中国专家共识[J].中华内科杂志,2013,52(1):76-82.
[12] European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm A J, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)[J]. Eur Heart J. 2010,31:2369-2429.
[13] Benjamin E J, Virani S S, Callaway C W, et al.Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association[J]. Circulation,2018,137(12): e67-e492.
[14] Ducharme A, Doyon O, White M, et al.Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial[J]. CMAJ, 2005,173(1):40-45.
[15] Howlett J G, Mann O E, Baillie R, et al.Heart failure clinics are associated with clinical benefit in both tertiary and community care settings: data from the Improving Cardiovascular Outcomes in Nova Scotia (ICONS) registry[J]. Can J Cardiol. 2009,25(9):e306-e311.
[16] Joung B, Lee J M, Lee K H, et al.KHRS Atrial Fibrillation Guideline Working Group. 2018 Korean guideline of atrial fifibrillation management[J]. Korean Circ J 2018;48(12):1033-1080.
[17] Marco P, Francesco R G, Brian O, et al. Improved Outcomes by Integrated Care of Anticoagulated Patients with Atrial Fibrillation Using the Simple ABC (Atrial Fibrillation Better Care) Pathway[J]. Am J Med, 2018, 131(11):1359-1366.e6.
[18] Daniele P, Pasquale P, Danilo M, et al.Integrated Care Management of Patients With Atrial Fibrillation and Risk of Cardiovascular Events: The ABC (Atrial fibrillation Better Care) Pathway in the ATHERO-AF Study Cohort[J]. Mayo Clin Proc, 2019, 94: 1261-1267.
[19] Minjae Y, Pil-Sung Y, Eunsun J, et al.Improved Population-Based Clinical Outcomes of Patients with Atrial Fibrillation by Compliance with the Simple ABC (Atrial Fibrillation Better Care) Pathway for Integrated Care Management: A Nationwide Cohort Study[J]. Thromb Haemost, 2019, 19(10): 1695-1703.
[20] 俞娅娅,李小荣,余金波,等.心房颤动综合管理ABC方案[J].中国心脏起搏与心电生理杂志,2020,34(1):7-10.