冠状动脉支架置入术后戒烟现状及健康教育对戒烟率的影响

摘要

目的：了解有吸烟嗜好冠心病患者冠状动脉支架置入后戒烟现状及健康教育对戒烟的影响，针对性地为健康教育提供依据。方法选取2009年1月至2014年6月第三军医大学大坪医院心血管内科行冠状动脉支架置入且有吸烟嗜好的患者217例，按随访情况随机分为规律随访组（n=119）和未规律随访组（n=98），按年龄分为小于45岁组（n=22）、45～<60岁组（n=87）、≥60岁组（n=108）。对调查对象进行现场调查或电话调查，主要内容包括出院后戒烟情况、戒烟失败原因等。结果217例患者中成功戒烟115例（53.00%），其中规律随访组戒烟率明显高于未规律随访组，而复吸率低于未规律随访组，差异均有统计学意义（P<0.01）；45～<60岁组患者成功戒烟率最低，而复吸率最高，分别与小于45岁组和≥60岁组比较，差异均有统计学意义（P<0.05）；＜45岁组患者戒烟失败的主要原因为身边人吸烟，45～<60岁组为工作压力，≥60岁组为个人习惯。结论健康宣教有利于冠状动脉支架置入术后患者戒烟率的提高。戒烟失败的主要原因在不同的年龄段有所不同，应根据年龄段、对象制订不同的辅助戒烟方案。%Objective To understand the status quo of quitting smoking in the patients with coronary atherosclerotic heart disease and smoking habit after the coronary stent implantation and the influence of health education on their smoking quit-ting behavior so as to pertinently provide references for the health education. Methods Totally 217 patients with smoking habit performed the coronary stent implantation in the cardiology department of Daping Hospital of Third Military Medical University from January 2009 to June 2014 were selected and randomly divided into the regular follow up group (n=119) and the non-regular follow up group(n=98) according to the follow-up situation,and the<45 years old group(n=22),45-<60 years old group(n=87) and≥60 years old group(n=108) according to the age. Then the respondents were performed the field survey or telephone survey , the main contents included the smoking situation after discharge from hospital,reasons of smoke quitting failure,etc. Results Among 217 cases,115 cases(53.00%)were successful in smoke quitting,in which the smoke quitting rate in the regular follow up group was significantly higher than that in the non-regular follow-up group,while the re-smoking rate was lower than that in the non-regular follow up group,the differences were statistically significant(P<0.01);the 45-<60 years old group had the lowest suc-cessful smoke quitting rate and highest re-smoking rate,the differences had statistical significance compared with the<45 years old group and the≥60 years old group(P<0.05);the main reason of smoke quitting failure in the<45 years old group was the around people smoking,which in the 45-<60 years old group was the working pressure and which in the>60 years old group was the personal habit. Conclusion The health education conduces to increase the quitting smoking rate in the patients after coro-nary stent implantation. The main reason for smoke quitting failure is different in different age groups ,so different auxiliary quit-ting smoking schemes should be formulated according to the different ages and subjects.