延续性管理模式在慢性心力衰竭患者中的应用

Application of continuity management model in chronic heart failure patients

目的探讨延续性管理模式在慢性心力衰竭患者中的应用效果。方法选择首都医科大学附属北京世纪坛医院2016年1月~2018年1月连续性收集的慢性心力衰竭患者115例进行研究,按入院顺序将患者分为对照组45例和观察组70例。比较两组患者生活质量评分、社会支持评分、焦虑评分、抑郁评分情况,6 min步行试验(6 MWT)、左心室射血分数(LVEF)、血浆氨基末端脑钠肽前体(NT-pro BNP)情况,随访1年,记录再次入院率、死亡率情况。结果两组患者管理模式实施前生活质量评分、社会支持评分、焦虑评分、抑郁评分、6 MWT、LVEF、NT-pro BNP比较,差异均无统计学意义(均P>0.05),管理模式实施后,对照组和观察组生活质量评分、社会支持评分、6 MWT、LVEF均高于本组管理模式实施前,焦虑评分、抑郁评分、NT-pro BNP均低于本组管理模式实施前,且观察组患者生活质量评分、社会支持评分、6 MWT、LVEF均高于对照组,焦虑评分、抑郁评分均低于对照组,差异均有统计学意义(均P<0.05),两组患者管理模式实施后NT-pro BNP比较,差异无统计学意义(P>0.05)。观察组患者1年内再次入院率、死亡率均低于对照组,差异均有统计学意义(均P<0.05)。结论延续性管理模式在慢性心力衰竭患者中应用,明显提高了患者的生活质量、社会支持,改善了不良心理情绪,提高了运动耐量,降低了复发和死亡率。

Objective To explore the effect of continuous management mode in patients with chronic heart failure.Method A total of 115 patients with chronic heart failure from Beijing Shijitan Hospital,Capital Medical University from January 2016 to January 2018 were selected for the study,the patients were divided into control group 45 cases and observation group 70 cases according to the order of admission.The quality of life score,social support score,anxiety score and depression score of the two groups were investigated,the 6 min walking test(6 MWT),left ventricular ejection fraction(LVEF)and plasma amino-terminal brain natriuretic peptide precursor(NT-pro BNP)were compared.Follow-up was conducted for 1 year to record readmission rate and mortality.Results There were no statistically significant differences in quality of life score,social support score,anxiety score,depression score,6 MWT,LVEF,NT-pro BNP before the implementation of management mode between the two groups of patients(all P>0.05).There were statistically significant differences in the management model,after the implementation of the quality of life scores in the control group and observation group,social support score,6 MWT,LVEF were higher than before the implementation of this management mode,anxiety score,depression score,NT-pro BNP were lower than before the implementation of this management mode,and the observation group of patients quality of life scale,social support score,6 MWT,LVEF were higher than the control group,the anxiety score,depression score were lower than the control group,the difference had statistical significance(P<0.05).There was no significant difference in NT-pro BNP between the two groups after the implementation of the management mode(P>0.05).The readmission rate and mortality rate in the observation group within 1 year were lower than those in the control group,with statistically significant differences(all P<0.05).Conclusion The application of continuous management mode in patients with chronic heart failure significantly improved the quality of life,social support,improved the poor psychological mood,improved the exercise tolerance,and reduced the recurrence and mortality.