基于脉搏指数连续心输出量监测的整体护理在重症心力衰竭患者中的应用

Holistic nursing based on pulse index continuous cardiac output monitoring in patients with severe heart failure

目的:观察在重症心力衰竭患者中实施基于脉搏指数连续心输出量监测整体护理的应用价值。方法:纳入2020年1月—2021年12月于重症加强护理病房(ICU)治疗的重症心力衰竭患者72例,随机分为观察组与对照组,每组36例。对照组予以常规护理措施,观察组在此基础上予以基于脉搏指数连续心输出量监测的整体护理。监测两组患者血流动力学指标及血清N-末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白I/T(cTnI/T)水平,并记录治疗期间并发症发生情况。结果:干预前两组患者各项指标比较差异无统计学意义(P>0.05)。干预后观察组患者心率(HR)、体循环阻力指数(SVRI)、血管外肺水(EVLW)及肺毛细血管通透指数(PVPI)较对照组降低,心脏指数(CI)、全心射血分数(GEF)以及全心舒张末期容积指数(GEDI)较对照组升高,且观察组患者NT-proBNP,cTnI/T水平以及并发症发生率低于对照组(P<0.05)。结论:基于脉搏指数连续心输出量监测的整体护理有助于进一步改善ICU重症心力衰竭患者的心功能,降低并发症发生风险。

Objective:To observe the application value of holistic nursing based on pulse index continuous cardiac output monitoring with severe heart failure.Methods:A total of 72 patients with severe heart failure hospitalized in intensive care unit(ICU)of hospital from January 2020 to December 2021 were enrolled and randomly divided into observation group and reference group with 36 patients in each group.The reference group was given conventional drug therapy and nursing measures,and the observation group was given holistic nursing based on continuous cardiac output monitoring of pulse index on this basis.Hemodynamic indexes,serum N-terminal pro-brain natriuretic peptide(NT-probNP)and troponin T(cTnI/T)levels of patients in the two groups were monitored,and the incidence of complications during treatment was recorded.Results:There was no significant difference between the two groups before intervention(P>0.05).After intervention,heart rate(HR),system vascular resistance index(SVRI),extravascular lung water(EVLW)and pulmonary vascular permeability index(PVPI)in the observation group were lower than those in the reference group,cardiac index(CI),whole-heart ejection fraction (GEF) and end-diastolic volume index(GEDI) were further higher than those in the reference group,and the levels of NT-probNP,cTnI/T and the incidence of complications in the observation group were lower than those in the reference group ( P <0.05).Conclusion:Holistic nursing based on continuous cardiac output monitoring of pulse index can further improve the cardiac function of ICU patients with severe heart failure and reduce the risk of complications.