慢性心力衰竭患者应用医共体同质化管理后的心血管功能及生活质量的变化  

Changes of cardiovascular function and quality of life in patients with chronic heart failure after medical community homogenization management

作　　者：许艳 薛琳[2] 王艳川 舒媛媛[1] 王压美 XU Yan;XUE Lin;WANG Yan-chuan;SHU Yuan-yuan;WANG Ya-mei(Department of General Medicine,Panzhihua Central Hospital,Panzhihua,Sichuan,617000,China)

机构地区：[1]攀枝花市中心医院全科医学科,四川攀枝花617000 [2]攀枝花市中心医院血透室,四川攀枝花617000

出　　处：《心血管康复医学杂志》2025年第2期241-246,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨慢性心力衰竭(CHF)患者应用医共体同质化管理(MCHM)对其自护能力、心功能、血管内皮功能、生活质量等的影响。方法:选择2021年4月至2023年4月攀枝花市中心医院收治的CHF患者110例,依据随机数字表法分为干预组(55例)和对照组(55例),对照组行常规管理,干预组在对照组基础上行MCHM,两组均干预3个月。比较两组患者自护能力、心功能、血管内皮功能、生活质量及不良事件发生情况。结果:与对照组比较,干预组心力衰竭自我护理指数(SCHFI)总分[(82.30±2.98)分比(59.46±3.19)分]、每搏输出量(SV)[(73.30±2.31)ml比(54.66±1.96)ml]、左心室射血分数(LVEF)[(58.25±2.90)%比(52.41±2.52)%]、舒张早期/舒张晚期最大血流速度(E/A)[(1.95±0.18)比(1.30±0.16)]、一氧化氮(NO)[(106.70±4.44)μmol/L比(82.36±4.66)μmol/L]水平均显著更高(P均<0.001),左心室舒张末期内径(LVEDd)[(49.79±1.58)mm比(56.49±2.17)mm]、内皮素-1(ET-1)[(36.66±2.65)ng/L比(46.88±2.66)ng/L]、明尼苏达心衰患者生活质量量表(MLHFQ)总分[(36.12±3.23)分比(54.67±3.35)分]均显著降低(P均<0.001)。干预组干预后不良事件发生率显著低于对照组(7.27%比25.45%,P=0.010)。结论:CHF患者采用MCHM可以显著改善其自护能力、心功能、血管内皮功能及生活质量,且具有较高安全性。Objective:To investigate the effect of medical community homogenization management(MCHM)on self-care ability,heart function,vascular endothelial function and quality of life in patients with chronic heart failure(CHF).Methods:This randomized controlled study enrolled 110 CHF patients admitted in Panzhihua Central Hospital between April 2021 and April 2023.They were divided into intervention group(n=55)and routine group(n=55).The control group received routine management,while intervention group received additional MCHM,both groups were intervened for 3 months.Self-care ability,heart function,vascular endothelial function,quality of life and incidence of adverse events were compared between two groups.Results:Compared with patients in control group,those in intervention group had significant higher total score of self-care of heart failure index(SCHFI)[(82.30±2.98)points vs.(59.46±3.19)points],stroke volume(SV)[(73.30±2.31)ml vs.(54.66±1.96)ml],left ventricular ejection fraction(LVEF)[(58.25±2.90)%vs.(52.41±2.52)%],early diastolic peak flow velocity/late diastolic peak flow velocity(E/A)[(1.95±0.18)vs.(1.30±0.16)]and the level of nitric oxide(NO)[(106.70±4.44)μmol/L vs.(82.36±4.66)μmol/L](P<0.001 all),and significant lower left ventricular end-diastolic diameter(LVEDd)[(49.79±1.58)mm vs.(56.49±2.17)mm],endothelin-1(ET-1)[(36.66±2.65)ng/L vs.(46.88±2.66)ng/L],Minnesota living with heart failure questionnaire(MLHFQ)total score[(36.12±3.23)points vs.(54.67±3.35)points](P<0.001 all).Patients in intervention group had significant lower incidence of adverse events comparing to those in control group(7.27%vs.25.45%,P=0.010).Conclusion:Medical community homogenization management could significantly improve self-care ability,heart function,vascular endothelial function and quality of life with good safety in CHF patients.

关 键 词：心力衰竭 护理 康复 

分 类 号：R541.61[医药卫生—心血管疾病]