心力衰竭疾病管理对患者预后的影响  

Effects of heart failure disease management on outcome of patients with heart failure

作　　者：孙强[1] 王宝英[2] 王庆胜[1] 邹晓译[1] 张扬[1] 郝佳[1] 谭强[1] 张双月[1] SUN Qiang WANG Baoying WANG Qingsheng ZOU Xiaoyi ZHANG Yang HAO Jia Tan Qiang ZHANG Shuangyue(Department of Cardiology, the First Hospital of Qinhuangdao, Qinhuangdao, 066000, China Department of Cardiology, the Third Hospital of Qinhuangdao)

机构地区：[1]秦皇岛市第一医院心内科,河北秦皇岛066000 [2]秦皇岛市第三医院心内科

出　　处：《临床心血管病杂志》2017年第2期165-168,共4页Journal of Clinical Cardiology

基　　金：秦皇岛市科技支撑计划项目(No:201502A076)

摘　　要：目的:探讨心力衰竭(心衰)疾病管理对患者心衰知识、心衰自我照顾能力及心衰恶化再住院的影响。方法:选择在我院心内科首诊为心衰的住院患者111例,随机分为管理组(56例)和对照组(55例),管理组给予心衰疾病管理模式,对照组给予常规诊疗及随访模式;测量工具为心衰知识量表和心衰自我照顾量表,同时收集患者的心衰再住院率及病死率情况。结果:入组时2组患者的心衰知识得分及心衰自我管理能力无明显差异。3个月随访时,2组患者的心衰知识得分均明显提高(P<0.05),2组对心衰自我照顾的维持、管理和信心评分均显著提高(P<0.05),且管理组较对照组改善明显(P<0.05);通过3个月随访,2组分别有9例(16.1%)和20例(36.4%)患者发生心衰再住院[风险比(HR)=0.423,95%可信区间(CI):0.190~0.943,P=0.035]。结论:心衰疾病管理的实施可以提高患者的心衰相关知识,且能够有效地实施自我照顾,显著降低患者心衰再住院率。Objective：To investigate the effectiveness of heart failure（HF）disease management on patient＇s knowledge about HF,self-care and hospital readimission for HF.Method：A total of 111 cases of first hospitalization with a primary diagnosis of HF were randomly assigned to management group（56patients）with HF disease management or control group（55patients）without management.We measured the Dutch Heart Failure Knowledge Scale（DHFKS）,the Self-Care Heart Failure Index（SCHFI）.Furthermore,we assessed HF rehospitalizations and mortality rates within 3 month after discharge.Result：There were no significant differences between two groups in the score of the DHFKS,self-care maintance,self-care management and self-care confidence.The two groups showed significant differences in the score of the DHFKS,self-care maintance,self-care management and self-care confidence.Meanwhile,the management group showed a significantly higher score at 3month follow-up.During the 3month follow-up,9（16.1%）patients in management group and 20（36.4%）patients in control group were hospitalized for HF（HR=0.423,95%CI：0.190~0.943,P=0.035）.Conclusion：HF management can increase patients HF knowledge,improve self-care ability and reduce rehospitalization of HF.

关 键 词：心力衰竭疾病管理 心力衰竭知识 自我照顾 再住院率 

分 类 号：R542.2[医药卫生—心血管疾病]