CAJ | 학술논문

目的：探讨药物治疗联合宣传教育和康复锻炼及定期随诊对慢性心力衰竭（ CHF）的治疗效果。方法208例CHF患者随机分成两组，对照组103例，采用慢性心衰的常规疗法：治疗原发病和合并症及诱发因素，并给予血管紧张素转化酶抑制剂（ ACEI）或血管紧张素受体拮抗剂（ ARB）、β－受体阻滞剂和间断运用利尿剂及洋地黄制剂等常规治疗。治疗组105例，在常规治疗基础上，指导患者进行康复锻炼和教育患者学会自我管理及定期随诊。结果治疗3个月后，治疗组总疗效与对照组相比有统计学意义（χ2＝5．84，P＜0．05），治疗组脑利钠肽（BNP）、左室舒张末期内径（LVDd）均小于对照组（P＜0．05），而6 min步行试验距离（m）、射血分数（EF）和心输出量（CO）均大于对照组（P＜0．05）。三年内治疗组患者的累计再住院率、人均住院天数和死亡率均少于对照组（ P＜0．05）。结论药物联合康复锻炼和教育患者学会自我管理及定期随诊治疗CHF，可改善患者的临床症状、心功能，提高生活质量，减少住院天数和降低住院率及死亡率。
목적：탐토약물치료연합선전교육화강복단련급정기수진대만성심력쇠갈（ CHF）적치료효과。방법208례CHF환자수궤분성량조，대조조103례，채용만성심쇠적상규요법：치료원발병화합병증급유발인소，병급여혈관긴장소전화매억제제（ ACEI）혹혈관긴장소수체길항제（ ARB）、β－수체조체제화간단운용이뇨제급양지황제제등상규치료。치료조105례，재상규치료기출상，지도환자진행강복단련화교육환자학회자아관리급정기수진。결과치료3개월후，치료조총료효여대조조상비유통계학의의（χ2＝5．84，P＜0．05），치료조뇌리납태（BNP）、좌실서장말기내경（LVDd）균소우대조조（P＜0．05），이6 min보행시험거리（m）、사혈분수（EF）화심수출량（CO）균대우대조조（P＜0．05）。삼년내치료조환자적루계재주원솔、인균주원천수화사망솔균소우대조조（ P＜0．05）。결론약물연합강복단련화교육환자학회자아관리급정기수진치료CHF，가개선환자적림상증상、심공능，제고생활질량，감소주원천수화강저주원솔급사망솔。
Objective To explore the therapeutic effect of drug treatment and rehabilitation exercises joint with public education and regular follow-up in the treatment of chronic heart failure ( CHF) .Methods 208 cases of patients with CHF were randomly divided into control group of 103 cases and treatment group of 105 cases.The control group adopted conventional therapy for the treatment of the primary disease, complications and predisposing factors, and they were given angiotensin converting enzyme inhibitors ( ACEI ) or angiotensin receptor antagonist ( ARB) ,β-blockers and intermittent use of diuretics and digitalis preparations and other conventional treatment.On the basis of the conventional therapy, the treatment group was guided to do rehabilitation exercises, learn self-management education and received regular follow-up.Results After 3 months of treatment, comparing with the control group, the effective rate of the treatment group was statistically significant (χ2 =5.84, P <0.05).The brain natriuretic peptide ( BNP) and left ventricular end-diastolic diameter ( LVDd) of the treatment group were less than those of the control group (P<0.05).While 6min walk test distance (m), ejection fraction (EF) and cardiac output ( C0 ) of the treatment group were higher than those of the control group ( P<0.05 ) .Accumulated within three years in patients treated with readmission rates, average length of stay and mortality rates of the treatment group were less than those of the control group(P<0.05).Conclusion The drug therapy combination of rehabilitation exercise, self-management education and regular follow-up of patients in treating CHF can improve clinical symptoms and heart function, improve quality of life, and reduce the length of hospital stay, lower hospitalization rates and mortality.