控水能力品管圈实践对心脏瓣膜病伴心衰患者整体心功能维护影响

Effect of water control ability and quality control circle on the maintenance of overall cardiac function in patients with heart valve disease and heart failure

目的探讨控水能力品管圈实践活动(QCC)对心脏瓣膜病伴发心力衰竭患者整体心功能维护的影响结果。方法选取我院心脏大血管外科2019年1-12月间收治的心脏瓣膜病伴心力衰竭患者120例,将2019年7月QCC开展之前的60例患者设为对照组,将QCC开展之后的60例患者设为观察组。对比两组患者入院前、入院第3天、术前及术后4个月的饮水量达标情况、心功能分级、水肿程度及术前和术后4个月的整体心功能情况。结果两组入院时心功能分级(NYHA)、水肿分级、入院前饮水达标率比较差异无统计学意义(P>0.05);观察组入院第3天、术前及术后4个月的饮水达标率均明显高于对照组(P<0.05);观察组心功能及心力衰竭症状各项指标中左心室舒张末期内径及射血分数、左心室舒张和收缩末期容积术前与对照组比较差异无统计学意义(P>0.05),术后随访期4个月均明显优于对照组,差异有统计学意义(P<0.05)。结论通过开展控水能力品管圈实践活动,心脏瓣膜病伴心衰患者控水能力明显提升,控水达标率明显提高,心功能明显好转,心力衰竭症状如乏力、心悸、呼吸困难及水肿明显减轻,可明显提高患者心功能的维护,促进患者术后早期康复。

Objective To explore the effect of quality control circle(QCC)for water control on the mainte-nance of overall heart function in patients with heart valve disease and heart failure.MethodsA total of 120 pa-tients with heart valve disease and heart failure admitted to our department from January 2019 to December 2019 were included in the study,with 60 of them before the implementation of QCC in July 2019 as the control group andanother 60 after the implementation of QCC as the observation group.The two groups were compared in terms of thecompliance rates of drinking water before admission,3 days after admission,right before operation and 4 months af-ter operation,the classification of cardiac function,the degree of edema,and the maintenance of overall cardiacfunction right before operation and 4 months after operation.ResultsThere was no significant difference betweenthe two groups in the heart function grading(NYHA),edema grading,and drinking water compliance rate before ad-mission(P>0.05).The drinking water compliance rates of the observation group were significantly higher than thecontrol group on the 3 rd day of admission,before surgery,and 4 months after surgery,respectively(P<0.05).There were no significant differences between the two groups in respect to the left ventricular end-diastolic diameterand ejection fraction as well as the left ventricular diastolic and end-systolic volume of the heart functionbefore opera-tion(P>0.05),but within the 4 months follow-ups after operation all the indicators involving the heart failure in theobservation group were significantly better than in the control group(P<0.05).ConclusionThrough the practiceof QQC for water control,the water control ability of patients with heart valve disease and heart failure is significantlyimproved,the water control compliance rate is significantly improved,the heart function is significantly improved,and the symptoms of heart failure such as fatigue,palpitation,dyspnea and edema are significantly reduced as well.The maintenance of cardiac function can promote the early recovery of patients after surgery.