奥马哈理论介入管理对心衰患者疗效及随访期间MACE发生率的影响  

Effect of Omaha system interventional management on therapeutic effect and the incidence of MACE during follow-up in patients with heart failure

作　　者：高歌 程苗苗 杨敏 鲍梅梅 张雨甜 GAO Ge;CHENG Miao-miao;YANG Min;BAO Mei-mei;ZHANG Yu-tian(Department of Cardiovascular Medicine,Second Affiliated Hospital of Chinese PLA Air Force Military Medical University,Xi'an,Shaanxi,710038,China)

机构地区：[1]中国人民解放军空军军医大学第二附属医院心血管内科,陕西西安710038

出　　处：《心血管康复医学杂志》2025年第2期261-265,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究奥马哈理论介入管理对心力衰竭(HF)患者疗效及随访期间主要不良心血管事件(MACE)发生率的影响。方法:选择2021年1月至2023年1月期间于中国人民解放军空军军医大学第二附属医院就诊的110例HF患者作为研究对象,采用随机数字表法均分为干预组和对照组。对照组采用常规护理,干预组采用基于奥马哈理论系统介入管理。两组均干预1个月并随访6个月。对比两组心功能、不良情绪、自我护理能力和生活质量,以及随访6个月期间MACE的累积发生率。结果:干预后,与对照组相比,干预组左心室射血分数(LVEF)[(60.32±4.79)%比(50.11±4.58)%]、自我护理能力量表(ESCA)[(142.33±6.58)分比(89.26±7.19)分]和生活质量综合评定问卷-74(GQOLI-74)[(88.61±4.15)分比(70.59±7.85)分]评分均显著更高(P均<0.001);左心房内径(LAD)[(36.18±2.98)mm比(40.25±3.05)mm]、左室收缩末期内径(LVESd)[(42.11±3.46)mm比(48.49±3.78)mm]、医院焦虑抑郁量表HADS(A)[(10.05±2.11)分比(14.33±2.05)分]和HADS(D)[(9.15±1.31)分比(13.37±2.18)分]评分显著更低(P均<0.001)。干预组MACE发生率为9.09%,显著低于对照组29.09%(P=0.004)。结论:奥马哈理论介入管理可显著改善心力衰竭患者的心功能和不良情绪,提升自我护理能力和生活质量,并降低随访期间MACE的发生率。Objective:To investigate the effect of Omaha system interventional management on therapeutic effect and incidence of major adverse cardiovascular events(MACE)during follow-up in patients with heart failure(HF).Methods:This randomized controlled study enrolled 110 HF patients treated in Second Affiliated Hospital of Chinese PLA Air Force Military Medical University between January 2021 and January 2023.They were divided into control group(n=55,routine nursing)and intervention group(n=55,interventional management based on Omaha system).Both groups received intervention for 1 month and were followed up for 6 months.The heart function,negative emotion,self-care capacity,quality of life,and cumulative incidence of MACE during the 6-month follow-up were compared between two groups.Results:Compared with patients in the control group,those in the intervention group had significant higher left ventricular ejection fraction(LVEF)[(60.32±4.79)%vs.(50.11±4.58)%],scores of exercise of self-care agency(ESCA)[(142.33±6.58)points vs.(89.26±7.19)points]and General Quality of Life Inventory 74(GQOLI-74)[(88.61±4.15)points vs.(70.59±7.85)points](P<0.001 all),and significant lower left atrial diameter(LAD)[(36.18±2.98)mm vs.(40.25±3.05)mm],left ventricular end-systolic diameter(LVESd)[(42.11±3.46)mm vs.(48.49±3.78)mm],scores of hospital anxiety and depression scale[HADS(A)][(10.05±2.11)points vs.(14.33±2.05)points]and HADS(D)[(9.15±1.31)points vs.(13.37±2.18)points](P<0.001 all).The incidence rate of MACE in intervention group(9.09%vs.29.09%)was significantly lower than that of control group(P=0.004).Conclusion:Omaha system interventional management could significantly improve cardiac function and negative emotions,improve self-care capacity and quality of life,and reduce the incidence of MACE during follow-up in patients with heart failure.

关 键 词：心力衰竭 奥马哈理论 护理 

分 类 号：R541.61[医药卫生—心血管疾病]