Yu Sujun, Wei Dan, Shi Nian
CCU, Wuhan Asia Cardiology Hospital Wuhan, Hubei, China.
PICU, Wuhan Asia Cardiology Hospital Wuhan, Hubei, China.
Am J Transl Res. 2023 Aug 15;15(8):5239-5248. eCollection 2023.
This study was designed to explore the efficacy of comprehensive nursing intervention in elderly patients with severe heart failure (SHF) treated by recombinant human brain natriuretic peptide (rh-BNP).
A retrospective analysis was made on 131 patients with SHF treated with rh-BNP in Wuhan Asia Cardiology Hospital from May 2019 to May 2022. Of them, 71 patients who received routine nursing care between May 2019 and December 2021 were assigned to the control group, and 60 patients who received comprehensive nursing between January 2022 and May 2022 were assigned to the observation group. The changes in quality of life (QoL) before and after nursing and the occurrence of adverse events after nursing were counted and compared between the two groups. The two groups were compared reagarding changes in anxiety and depression scores before and after nursing, as well as hospitalization expenses and hospitalization time. The left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) of patients were determined. The nursing satisfaction of the two groups was evaluated. Additionally, logistic regression was carried out to analyze the risk factors for adverse events.
The control group had lower QoL scores than the observation group after nursing (P < 0.0001). The control group got significantly higher self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores than the observation group (P < 0.0001). The control group showed lower levels of LVEDV and LVEF than the observation group (P < 0.0001). The control group experienced greatly longer hospitalization time than the observation group, and also had a higher hospitalization expense than the observation group (P < 0.001). The observation group expressed much higher nursing satisfaction than the control group (P=0.007). Additionally, according to multivariate logistic regression analysis, age, hypertension, and diabetes mellitus were independent risk factors for adverse events (P < 0.05).
For elderly SHF patients treated by rh-BNP, comprehensive nursing intervention can contribute to higher QoL, shorter hospitalization time, lower hospitalization expense, and milder negative emotions, but did not correlate with short-term adverse cardiovascular events.
本研究旨在探讨综合护理干预对重组人脑利钠肽（rh-BNP）治疗老年重度心力衰竭（SHF）患者的疗效。
回顾性分析2019年5月至2022年5月在武汉亚洲心脏病医院接受rh-BNP治疗的131例SHF患者。其中，2019年5月至2021年12月接受常规护理的71例患者被分配到对照组，2022年1月至2022年5月接受综合护理的60例患者被分配到观察组。统计并比较两组护理前后生活质量（QoL）的变化以及护理后不良事件的发生情况。比较两组护理前后焦虑和抑郁评分的变化，以及住院费用和住院时间。测定患者的左心室舒张末期容积（LVEDV）和左心室射血分数（LVEF）。评估两组的护理满意度。此外，进行逻辑回归分析不良事件的危险因素。
护理后对照组的QoL评分低于观察组（P < 0.0001）。对照组的自评焦虑量表（SAS）和自评抑郁量表（SDS）评分显著高于观察组（P < 0.0001）。对照组的LVEDV和LVEF水平低于观察组（P < 0.0001）。对照组的住院时间比观察组长得多，住院费用也高于观察组（P < 0.001）。观察组的护理满意度远高于对照组（P = 0.007）。此外，根据多因素逻辑回归分析，年龄、高血压和糖尿病是不良事件的独立危险因素（P < 0.05）。
对于接受rh-BNP治疗的老年SHF患者，综合护理干预可提高生活质量、缩短住院时间、降低住院费用并减轻负面情绪，但与短期心血管不良事件无关。
