基于临床结局的干预策略在高血压合并心血管危险因素患者护理中的应用价值

Application value of intervention strategy based on clinical outcomes in the nursing of patients with hypertension complicated with cardiovascular risk factors

目的探究基于临床结局的干预策略在高血压合并心血管危险因素患者护理中的应用价值。方法回顾性分析2016年1月-2016年12月常州市第一人民医院收治的210例高血压患者的临床资料,按照是否合并心血管事件分为心血管事件组和无心血管事件组,分析影响高血压患者发生心血管事件的危险因素。另选取2018年2月-2018年6月常州市第一人民医院收治的84例高血压患者为研究对象,采用随机数字表法分为对照组和观察组,各42例。对照组患者给予常规护理干预,观察组患者在常规护理干预基础上给予基于心血管事件发生危险因素的针对性护理干预,比较两组患者1年后的心血管事件发生情况。结果心血管事件组的年龄、体质指数(BMI)、吸烟史、糖尿病、脂代谢异常率和纤维蛋白原(Fib)水平均显著高于无心血管事件组(P值均<0.05)。经Logistic回归分析显示,年龄≥65岁、BMI≥25 kg/m^(2),吸烟史、糖尿病、脂代谢异常和高Fib水平均为高血压患者发生心血管事件的独立危险因素(P值均<0.05)。观察组1年后心血管事件总发生率为9.52%,显著低于对照组的26.19%(P<0.05)。结论基于临床结局的护理干预策略在高血压合并心血管事件高危因素患者中应用效果显著,临床应用价值高。

Objective To explore the application value of intervention strategy based onclinical outcomes in the nursing of patients with hypertension and cardiovascular risk factors.Methods The clinical data of 210 patients with hypertension admitted to Changzhou FirstPeople's Hospital from January 2016 to December 2016 were retrospectively analyzed.Theywere divided into a cardiovascular event group and a non-cardiovascular event group according towhether they were complicated with cardiovascular events.The risk factors of cardiovascularevents in patients with hypertension were analyzed.In addition,84 patients with hypertensionadmitted to Changzhou First People's Hospital from February 2018 to June 2018 were selected asthe research objects and randomly divided into a control group and an observation group by usinga random number table,with 42 cases in cach group.The control group was given routine nursing intervention,and the observation group was given targeted nursing intervention based onthe risk factors of cardiovascular events on the basis of routine nursing intervention.Theincidence of cardiovascular events in the two groups was compared after 1 year.Results The age,body mass index(BMI),smoking history,diabetes mellitus,abnormal lipid metabolismratc and fibrinogen(Fib)level of cardiovascular event group were significantly higher than thoseof the non-cardiovascular event group(all P<0.05).Logistic regression analysis showed that≥65 years of age,BMI≥25 k/m^(2),smoking history,diabetes mellitus,abnormal lipidmetabolism and high Fib level were independent risk factors for cardiovascular events in patientswith hypertension(all P<0.05).The total incidence of cardiovascular events in the observationgroup after 1 year was 9.52%,which was significantly lower than 26.19%in the control group(P<0.05).Conclusion The application effect of nursing intervention strategy based onclinical outcomes in patients with hypertension complicated with high risk factors ofcardiovascular events is significant,and the clinical application value is high.