舒适护理干预对慢性心力衰竭患者心功能及BNP水平的影响

Influence of comfortable nursing interventional measure on the cardiac function and BNP level in the patient with chronic heart failure

目的探讨舒适护理干预措施对慢性心力衰竭（CHF）患者心功能及B型脑钠肽（BNP）水平的影响。方法选取2014年1月～2015年8月心内科住院就诊的CHF患者84例,随机分为常规护理组和舒适护理组各42例。两组病例均予以血管扩张剂、洋地黄和利尿剂等治疗。常规护理组患者予以常规护理干预措施,包括饮食调整、心理安慰、基础护理及健康教育等常规护理。舒适护理组患者在此基础上加用舒适护理干预。两组均干预8周。观察并比较两组病例治疗前后治疗依从性、临床效果及BNP指标水平的变化。结果干预8周后,舒适护理组病例总依从率（95.24%）明显高于常规护理组（78.57%）（χ^2=5.13,P〈0.05）;护理干预组病例临床总有效率（92.86%）明显高于常规护理组（76.19%）（χ^2=4.46,P〈0.05）;同时两组病例血清BNP指标水平[（276.0±40.8）pg/m L、（348.4±50.2）pg/m L]较前[（404.7±60.3）pg/m L、（395.2±55.01）pg/m L]明显下降（P〈0.05）,且舒适护理组病例与常规护理组相比下降更明显（P〈0.05）。结论舒适护理干预用于CHF患者的疗效优于常规护理患者,更能提高患者治疗依从性,改善其心功能,其作用机制与其更能降低血清BNP指标水平密切相关。

Objective To investigate the influence of comfortable nursing interventional measures on the cardiac function and BNP level in the patients with chronic heart failure（CHF）. Methods 84 patients with CHF who were admitted to the department of cardiology of our hospital from January 2014 to August 2015 were selected and randomly divided into regualr nursing group and comfortable nursing group with 42 cases in each group. Therapy like vasodilators, digitalis and diuretics were given to the patients in both groups. Patients in the regular nursing group received regular nursing interventional measures including diet regulations, psychological comforting, basic nursing and health education.Comfortable nursing group adpoted the above measues adding comforable nursing intervention. Both groups received interventions for 8 weeks. Treatment compliance, clinical efficacy and BNP level of the patients in both groups before and after the therapy were observed and compared. Results After 8-week interventions, patients in comfortable nursing group had significant higher total compliance rate（95.24%） than that of regular nursing group（78.57%）（χ^2=5.13,P〈0.05）;Nursing intervention group patients clinical total effective rate（92.86%） was significantly higher than that of the conventional nursing group（76.19%）（χ^2=4.46, P〈0.05）. simultaneously, the serum BNP level in both groups [（276.0±40.8） pg/m L,（348.4±50.2） pg/m L] decreased significantly than before [（404.7 ±60.3） pg/m L,（395.2 ±55.01） pg/m L]（P〈0.05） and the decreasing rate of comfortable nursing group was more remarkable（P〈0.05）. Conclusion Comfortable nursing interventions for CHF patients have better efficacy than regular nursing interventions. They can better increase the treatment compliance and improve the cardiac function of the patients. The mechanism is closely associated with the fact that they can better decrease serum BNP level.