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目的:探讨心力衰竭(心衰)疾病管理对患者心衰知识、心衰自我照顾能力及心衰恶化再住院的影响。方法:选择在我院心内科首诊为心衰的住院患者111例,随机分为管理组(56例)和对照组(55例),管理组给予心衰疾病管理模式,对照组给予常规诊疗及随访模式;测量工具为心衰知识量表和心衰自我照顾量表,同时收集患者的心衰再住院率及病死率情况。结果:入组时2组患者的心衰知识得分及心衰自我管理能力无明显差异。3个月随访时,2组患者的心衰知识得分均明显提高(P<0.05),2组对心衰自我照顾的维持、管理和信心评分均显著提高(P<0.05),且管理组较对照组改善明显(P<0.05);通过3个月随访,2组分别有9例(16.1%)和20例(36.4%)患者发生心衰再住院[风险比(HR)=0.423,95%可信区间(CI):0.190~0.943,P=0.035]。结论:心衰疾病管理的实施可以提高患者的心衰相关知识,且能够有效地实施自我照顾,显著降低患者心衰再住院率。
Objective: To investigate the influence of disease management of heart failure (heart failure) on patients with heart failure, self-care ability of heart failure and hospitalization with deteriorating heart failure. Methods: A total of 111 inpatients with heart failure who were diagnosed as heart failure in our department were randomly divided into a management group (56 cases) and a control group (55 cases). The management group was given heart failure management and the control group received routine treatment And follow-up mode. The measurement tools were the knowledge scale of heart failure and the self-care scale of heart failure, and the hospitalization rate and case fatality rate of heart failure were also collected. Results: There were no significant differences in knowledge scores of heart failure and self-management of heart failure between the two groups at enrollment. At 3 months of follow-up, the knowledge scores of heart failure were significantly increased in both groups (P <0.05). The maintenance, management and confidence scores of two groups were significantly improved (P <0.05) The control group improved significantly (P <0.05). After 3 months of follow-up, 9 patients (16.1%) and 20 patients (36.4% Confidence Interval (CI): 0.190 ~ 0.943, P = 0.035]. Conclusion: The implementation of heart failure management can improve the knowledge of heart failure, and can effectively self-care, significantly reduce the re-admission rate of heart failure patients.