2022 年第 1 期 第 17 卷

延续性护理对慢性心力衰竭患者短期预后的影响

Impact of continuous nursing on the short-term prognosis in patients with chronic heart failure

作者：周新圆赵静静曾余佳张磊杨志云董建增

英文作者：Zhou Xinyuan Zhao Jingjing Zeng Yujia Zhang Lei Yang Zhiyun Dong Jianzeng

单位：首都医科大学附属北京安贞医院心内科心力衰竭中心国家心血管疾病临床医学研究中心，北京100029

英文单位：Heart Failure Center Department of Cardiology Beijing Anzhen Hospital Capital Medical University National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China

关键词：慢性心力衰竭；延续性护理；短期预后

英文关键词：Chronicheartfailure;Continuousnursing;Short-termprognosis 

• 摘要：

• 目的 分析延续性护理对慢性心力衰竭（CHF）患者短期预后的影响。方法 选取2020年1—12月首都医科大学附属北京安贞医院住院治疗的100例心力衰竭患者，采用随机数字表法分为观察组和对照组，每组50例。对照组给予常规出院指导，观察组在对照组的基础上实施为期3个月的延续性护理。所有患者随访6个月。评估并比较2组患者出院6个月后的心功能改善及药物使用情况。记录随访期间患者因CHF再入院和死亡情况。结果 100例患者中，98例患者完成了随访，对照组在随访3、6个月时分别有1例患者失访。入组时、出院6个月后，2组纽约心脏病协会心功能分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级比例比较差异均无统计学意义（均P＞0.05），但观察组心功能改善比例高于对照组［46.0%（23/50）比22.9%（11/48）］，差异有统计学意义（P＜0.05）。出院6个月后，观察组坚持服药患者比例高于对照组［90.0%（45/50）比85.4%（41/48）］，但2组间比较差异无统计学意义（P＞0.05）。随访期间，2组均无死亡病例，观察组因CHF再入院比例显著低于对照组［10.0%（5/50）比27.1%（13/48）］（P＜0.05）。结论  延续性护理有利于改善CHF患者的心功能并降低患者的再入院率。 ngzhou 510080, China; 5Traditional Chinese Medicine Studio, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China; 6Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China

• Objective   To analyze the impact of continuous nursing on the short-term prognosis in patients with chronic heart failure (CHF). Methods  From January to December 2020, 100 patients with CHF admitted to Beijing Anzhen Hospital, Capital Medical University were selected. They were randomly divided into the observation group and the control group, with 50 cases in each group. The control group was given routine discharge guidance, and the observation group was given continuous nursing for 3 months on the basis of the control group. All the patients were followed-up for 6 months. Six months after discharge from the hospital, the improvement of cardiac function and medication compliance were recorded. The rehospitalization due to CHF and death events of the two groups were recorded during the follow-up period. Results  Among all the 100 cases, 98 cases completed the follow-up, and 1 case in the control group was lost at each 3 and 6 months of follow-up. At enrollment and 6 months after discharge, there were no differences in proportions of New York Heart Association cardiac function grade Ⅰ, Ⅱ, Ⅲ and Ⅳ between the two groups (both P>0.05). The proportion of improvement of cardiac function in the observation group was higher than that in the control group［46.0%（23/50） vs 22.9%（11/48）］ (P<0.05). Six months after discharge, the proportion of adherence to medication in the observation group was higher than that in the control group［90.0%（45/50） vs 85.4%（41/48）］, but the difference was not statistically significant (P>0.05). During the follow-up period, there were no death in both groups, and the rehospitalization rate in the observation group was lower than that in the control group ［10.0%（5/50） vs 27.1%（13/48）］(P<0.05). Conclusion  For patients with CHF, continuous nursing is helpful to improve cardiac function and to reduce the rehospitalization rate.