出院健康教育医嘱单对缺血性卒中二级预防的影响

目的探讨提供出院健康教育医嘱单及其后续管理服务对缺血性卒中二级预防遵医行为的影响。方法将92例出院缺血性卒中患者随机分为对照组（n=46）、干预组（n=46），对照组做常规带药、出院指导，干预组给予出院健康教育医嘱单及其后续管理。1年后对两组患者调整行为危险因素遵医行为（戒烟限酒、控制体重、合理膳食、适度运动、自我监护、定时复诊）、控制血管危险因素遵医行为（服用降压、降糖、调脂、抗栓药物）、复发率、死亡率进行调查。结果干预组与对照组出院后1年内调整行为危险因素遵医行为、控制血管危险因素遵医行为、复发率、死亡率比较，差异有统计学意义（P〈0．01，P〈0．05），干预组遵医行为好于对照组。结论出院健康教育医嘱单及其后续管理，是提高缺血性卒中二级预防遵医行为的有效措施。

Effect of doctor' s order sheets on discharged health education on secondary prevention of patients with ischemic stroke

Objective To explore effects of doctor' s order sheets on discharged health education on secondary prevention and compliance with doctor' s advice among patients with ischemic stroke. Methods A total of 92 patients discharged from hospital with ischemic stroke were randomly divided into two groups, 46 in the control group and 46 in the intervention group. The patients of the former group were provided with conventional medicine and discharge guidance while those of the latter received doctor's advice sheets on health education for discharge and follow-up management. 1 year later patients of both groups were investigated on adjustment of behavioral risk factors in compliance with doctor' s advice (smoking-quitting and alcohol-limiting, weight control, reasonable diet, moderate exercise, self-monitoring, regular referral) , control of vascular risk factors in compliance with doctor' s advice (taking antihypertensive, glucose-lowering, lipid-lowering and antithrombotic drugs) and relapse rate and mortality rate. Results The difference between the intervention group and control group after 1 year discharged from hospital was statistically significant by comparison on adjustment of behavioral risk factors, control of vascular risk factors, relapse rate and mortality rate (P <0. 01, P < 0. 05). Behavior in compliance with doctor' s advice of the intervention group was significantly better than of the control group. Conclusions Doctor's order sheets on health education for discharge and follow-up management are effective measures to improve the secondary prevention of ischemic stroke in compliance with doctor' s advice.