环磷腺苷葡胺治疗老年充血性心力衰竭的效果及护理

Effect of meglumine adenosine cyclophosphate for senile congestive heart failure and nursing

目的 探讨环磷腺苷葡胺治疗老年充血性心力衰竭的临床效果,并提出使用环磷腺苷葡胺后的护理对策.方法 将81例患者采用随机数字表法随机分为观察组41例及对照组40例,在常规治疗的基础上,观察组使用环磷腺苷葡胺治疗并运用相应护理干预方法,对照组患者使用美托洛尔治疗,在所有患者入院后以及出院3个月随访时比较彩色心动图变化情况,并测定B型脑钠肽变化,统计两组患者治疗期间出现服药不规则和不良反应的发生情况.结果 治疗后观察组患者左室射血分数、左室短轴缩短率及心脏指数分别为（56.8±7.8）％,（39.1±5.3）％,（4.8 ±0.7）L/（min·m^2）,均高于对照组的（39.7±7.3）％,（30.8±4.6）％,（3.1±0.5）L/（min·m^2）,差异均有统计学意义（t分别为20.381,17.869,14.281;P＜0.01）；治疗前两组患者B型脑钠肽比较,差异无统计学意义（P＞0.05）；治疗后观察组患者B型脑钠肽值为（262.9±46.3） ng/L,低于对照组的（378.1±49.2） ng/L,差异有统计学意义（t=8.115,P＜0.05）；观察组患者出现多服少服、漏服以及不规律服用情况均低于对照组,同时出现心悸心慌不良反应数低于对照组,差异均有统计学意义（P＜0.05）.结论 使用环磷腺苷葡胺治疗充血性心力衰竭能较好的改善患者心功能,减缓甚至逆转心肌重塑,配合护理干预,能更好地提高患者依从性,改善治疗效果.

Objective To discuss clinical effect of meglumine adenosine cyclophosphate for senile congestive heart failure,and propose related nursing countermeasures.Methods Totals of 81 patients were randomly divided into the observation group （41 cases） and the control group （40 cases）.On the basis of routine treatment,the observation group received meglumine adenosine cyclophosphate and nursing intervention,while the control group received metoprolol treatment.Changes of color kinetocardiogram were compared on hospitalization and 3 months after discharge,and changes of B brain natriuretic peptide were monitored.Irregular medication and adverse reactions were also counted in two groups.Results After treatment,left ventricular ejection fraction,left ventricular fractional shortening rates and cardiac index were respectively （56.8 ± 7.8） %,（39.1 ± 5.3） %,（4.8 ± 0.7） L/（min · m^2） in the observation group and （39.7 ± 7.3） %,（30.8 ± 4.6） %,（3.1 ± 0.5） L/（min · m^2） in the control group,and the differences were statistically significant （t =20.381,17.869,14.281,respectively;P 〈 0.01）.There was no statistically significant difference of B brain natriuretic peptide between two groups before treatment （P 〉 0.05）.Mter treatment,B brain natriuretic peptide was （262.9 ± 46.3） ng/L in the observation group,lower than （378.1 ± 49.2） ng/L in the control group,and the difference was statistically significant （t =8.115,P 〈 0.05）.Multiple medication,less medication,omissions as well as irregular medication was less in the observation group than in the control group,rate of adverse reactions including heart-throb was lower in the observation group than in the control group,and the differences were statistically significant （P 〈 0.05）.Conclusions The use of meglumine adenosine cyclophosphate for congestive heart failure can effectively improve patients＇ cardiac function and slow down or even reverse myocardial remodeling.Nursing intervention together can enhance patients＇ compliance and improve treatment effect.