循证护理模式在慢性心力衰竭患者中的应用效果

Application of evidence-based nursing in patients with chronic heart failure

目的探讨循证护理在慢性心力衰竭患者中的临床应用效果。方法入选2013年1月-2015年2月在哈尔滨医科大学附属第二医院心内科接受治疗的慢性心力衰竭患者120例,男性59例,女性61例。根据抽签法随机分为治疗组与对照组,各60例。两组均给予标准药物治疗,治疗周期为3个月。在治疗期间对照组给予常规的心内科护理,治疗组给予循证护理。干预前后患者进行6 min步行试验测定心功能。两组干预后进行疗效判定以及采用慢性心力衰竭生存质量量表（SS-QOL）进行生活质量评定。结果与对照组比较,治疗组总有效率升高（81.7%vs.96.7%）,差异有统计学意义（P〈0.05）。两组干预后较干预前6 min步行距离均增加,差异有统计学意义（P均〈0.05）。治疗组干预后较对照组6 min步行距离增加[（469.29±15.13）m vs.（411.87±14.22）m],差异有统计学意义（P〈0.05）。两组干预后,慢性心力衰竭生存质量量表（SS-QOL）调查,治疗组的精力、家庭角色、语言、活动能力、情绪、个性、自理能力、社会角色等评分都明显高于对照组,差异有统计学意义（P均〈0.05）。结论循证护理较常规护理能够有效改善慢性心力衰竭患者心功能,提高治疗疗效和生活质量。

Objective To discuss the application effect of evidence-based nursing （EBN） in patients with chronic heart failure （CHF）. Methods CHF patients （n=120, male 59 and female 61） were chosen from Jan. 2013 to Feb. 2015, and then randomly divided into treatment group and control group （each n=60）. All groups were given conventional drug therapy for 3 m, and control group was given routine nursing of cardiology and treatment group was given EBN during treatment. The heart function was detected through 6-minute walk test （6MWT） in all patients before and after treatment. The curative effect was reviewed and quality of life （QOL） was evaluated by using stroke-specific quality of life （SS-QOL） in 2 groups after treatment. Results The total effective rate increased in treatment group compared with control group （81.7% vs. 96.7%, P〈0.05）. 6MWT increased in all 2 groups after treatment （all P〈0.05）, and was higher in treatment group than that in control group [（469.29± 15.13） m vs. （411.87±14.22） m, P〈0.05]. The results of SS-QOL showed that the scores in vigor, family role, language ability, mobility, emotion, personality, self-care ability and social roles were significantly higher in treatment group than those in control group after treatment （P〈0.05）. Conclusion EBN, compared with routine nursing, can effectively improve the heart function, curative effect and QOL in CHF patients.