精细化容量管理对慢性心力衰竭急性加重患者的影响  

Effects of the precise volume management on patients with acute exacerbation of Chronic Heart Failure

作　　者：王芳芳 文杰[1] 张慧颖 郭敏 李小红 WANG Fangfang;WEN Jie;ZHANG Huiying;GUO Min;LI Xiaohong(The Second Cardiology Department,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091,China)

机构地区：[1]中国中医科学院西苑医院心血管二科,北京市100091

出　　处：《中国护理管理》2024年第4期588-592,共5页Chinese Nursing Management

基　　金：中国中医科学院科技创新工程(C12021A03215)。

摘　　要：目的:分析精细化容量管理在慢性心力衰竭急性加重患者出院前后护理中的应用效果,以期进一步提高慢性心力衰竭急性加重患者的临床护理水平。方法:采用便利抽样法选择2022年9月至2023年3月在北京市某三级甲等医院心内科住院的60例慢性心力衰竭急性加重患者,随机分为对照组和实验组。对照组采用药物常规治疗加常规心内科护理,实验组在对照组的基础上进行精细化容量管理干预,评价精细化容量管理对住院天数、氨基末端脑钠肽前体、明尼苏达心力衰竭生活质量问卷、出院3个月心力衰竭再住院情况的影响。结果:实验组的住院天数明显短于对照组(P=0.024),且住院期间实验组的氨基末端脑钠肽前体下降水平优于对照组(P=0.025),干预2周后,实验组的明尼苏达心力衰竭生活质量问卷评分明显低于对照组(P=0.048),但实验组与对照组的出院3个月再住院情况比较,差异无统计学意义(P=0.731)。结论:精细化容量管理方法可行、有效,在不增加治疗成本的基础上,可以明显缩短慢性心力衰竭急性加重患者的住院时间,提高生活质量。Objective:To investigate the effects of the precise volume management in care of patients with acute exacerbation of Chronic Heart Failure.Methods:Sixty patients with acute exacerbation of Chronic Heart Failure hospitalized in the Cardiology Department of a tertiary grade A hospital in Beijing,were selected by convenience sampling method,and randomly assigned to either the control or experimental group from September 2022 to March 2023.Patients in the control group received conventional treatment and routine cardiology care,while patients in the experimental group received the precise volume management besides the routine care.The length of stay in hospital,the N-terminal pro-Brain Natriuretic Peptide(NT-proBNP)levels,the Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,and the readmission rate due to heart failure at three months were all collected and compared between the two groups.Results:Patients in the experimental group had significantly shorter length of stay in hospital than those in the control group(P=0.024).During the hospitalization,patients in the experimental group showed superior reductions in NT-proBNP levels compared to their counterparts in the control group(P=0.025).Two weeks after the intervention,MLHFQ scores in the experimental group were significantly lower than those in the control group(P=0.048).However,there was no statistically significant difference in the three-month readmission rate between the experimental and the control group(P=0.731).Conclusion:The precise volume management is a feasible and effective approach that can significantly reduce length of stay in hospital and enhances the quality of life in patients with acute exacerbation of Chronic Heart Failure.

关 键 词：慢性心力衰竭急性加重 精细化容量管理 护理 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]