Abstract: Objective　To investigate the effect of warfarin pathway table combined with feedback on the levels of anticoagulation cognition and self-management in patients after mechanical heart valve replacement. Methods　A total of 120 patients who underwent mechanical heart valve replacement in Cardiovascular Surgery, The First Affiliated Hospital of Henan University of Science and Technology from January 2020 to October 2021 were divided into two groups according to the order of admission. Due to the influence of critical conditions, loss of contact, and other factors, 55 cases in the control group and 57 cases in the observation group completed the study. The control group included 25 males and 30 females, aged (55.37±8.67) years; the observation group included 26 males and 31 females, aged (54.21±7.73) years. The control group was given health education guidance by feedback method, and the observation group was intervened by warfarin pathway table combined with feedback method. The two groups were tested for anticoagulation cognition level 4 h before discharge and self-management level 1 month after discharge and the results were statistically analyzed. Independent sample t test, χ² test, Fisher's exact probability test, and rank sum test were used. Results　The good rate of anticoagulation cognition level 4 h before discharge in the observation group was higher than that in the control group [78.9% (45/57) vs. 61.8% (34/55)], and the good rate of self-management level 1 month after discharge was higher than that in the control group [75.4% (43/57) vs. 54.5% (30/55)], with statistically significant differences between the two groups (both P<0.05). The total excellent and good rates of anticoagulation cognition level and self-management level were higher in both groups, but there were no statistically significant differences between the two groups (both P>0.05). Conclusion　Applying warfarin pathway table combined with feedback method to carry out systematic health education for patients after mechanical heart valve replacement can make full use of the superposition effect of efficient nursing, significantly increase their anticoagulation cognition level and self-management level, and improve their postoperative quality of life, which has a certain clinical value.

Key words: Warfarin pathway table, Feedback method, Anticoagulation cognition level, Self-management level

摘要： 目的　探讨华法林路径表结合回授法对机械瓣膜置换术后患者抗凝认知水平和自我管理水平的影响。方法　选取河南科技大学第一附属医院心血管外科2020年1月至2021年10月收治的120例行机械瓣膜置换术患者，按入院顺序分为两组，受患者病情危重、失联等因素影响，对照组配合完成研究55例，观察组配合完成研究57例。对照组男25例，女30例，年龄（55.37±8.67）岁；观察组男26例，女31例，年龄（54.21±7.73）岁。对照组采用回授法健康教育指导，观察组采用华法林路径表结合回授法进行干预。对两组患者出院前4 h进行抗凝认知水平测试，出院1个月后进行自我管理水平测试，分析两组患者结果差异。统计学方法采用独立样本t检验、χ²检验、Fisher确切概率法、秩和检验。结果　观察组患者出院前4 h抗凝认知水平良好率高于对照组［78.9%（45/57）比61.8%（34/55）］，出院1个月后的自我管理水平良好率高于对照组［75.4%（43/57）比54.5%（30/55）］，两组比较差异均有统计学意义（均P<0.05）。两组患者的抗凝认知水平总优良率、自我管理水平总优良率均较高，但两组比较差异均无统计学意义（均P>0.05）。结论　应用华法林路径表结合回授法对机械瓣膜置换术后患者进行健康教育，能充分发挥高效护理叠加效应，显著提高患者抗凝认知水平和自我管理水平，改善患者术后生活质量，具有一定临床价值。

关键词: 华法林路径表, 回授法, 抗凝认知水平, 自我管理水平