建立心衰门诊与降低慢性心力衰竭患者再住院率的临床观察

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目的探讨心衰门诊对慢性心力衰竭患者的影响。方法将慢性心力衰竭患者92例随机分成心衰门诊干预组(50例)和对照组(42例)。所有心力衰竭患者均按常规治疗。干预组随访医生和护士对每一个患者进行督导和干预,包括药物调整、健康教育、改良生活方式等。观察所有患者不良生活方式改变情况、遵医服药情况、住院次数、再住院率、住院总日数、病死率及医疗费用。结果干预组与对照组相比,在生活方式改良、遵医行为、住院次数、再住院率、住院总日数及医疗费用等方面均有显著差异(P<0.01);由于观察时间短,是否能降低死亡率有待进一步观察。结论通过心衰门诊对慢性心力衰竭患者加强干预,能提高病人对治疗及康复方案的依从性,可以有效的改善患者的生活质量,减少住院总日数,降低再住院率及医疗费用。 Objective To investigate the impact of heart failure clinic on patients with chronic heart failure. Methods 92 patients with chronic heart failure were randomly divided into intervention group (50 cases) and control group (42 cases). All patients with heart failure are treated as usual. The intervention group followed up with doctors and nurses to supervise and intervene each patient, including drug adjustment, health education and lifestyle improvement. All patients were observed changes in unhealthy lifestyles, medication compliance, hospitalization, rehospitalization, total hospitalization days, mortality and medical costs. Results Compared with the control group, there were significant differences (P <0.01) in life style improvement, compliance behavior, hospitalization frequency, rehospitalization rate, total length of hospitalization and medical expenses in the intervention group as compared with the control group; due to the short observation time, To reduce the mortality needs further observation. Conclusions Intensive intervention in patients with chronic heart failure through heart failure outpatient service can improve patients ’compliance with treatment and rehabilitation programs, effectively improve patients’ quality of life, reduce the total hospitalization days, reduce the rate of rehospitalization and medical expenses.
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