全方位护理干预对慢性心力衰竭合并低钠血症患者预后的影响

目的：探讨全方位护理干预对慢性心力衰竭合并低钠血症患者预后的影响效果。方法选取2011年1月-2013年12月山东日照市人民医院心内科收治的心力衰竭合并低钠血症患者共有100例，采用随机数字表法分为观察组与对照组，每组各50例，两组患者均给予常规药物治疗，对照组给予常规护理措施，观察组患者全方位护理干预4周。统计对比两组患者血钠水平、心功能的变化等预后指标。结果观察组的总有效率为96．0％，对照组患者的临床总有效率为72．0％，观察组患者的总有效率显著高于对照组患者，差异有统计学意义（χ2＝10．7，P＜0．01）。观察组患者治疗后心脏彩超指标：LVESD、LVEDD、LVEF％分别为（43．3±6．9）mm、（53．4±5．0）mm、（53．8±8．5）％，均优于对照组，差异有统计学意义（t值分别为-4．0，-2．7，7．5；P＜0．01）；两组患者治疗前后组内比较差异均有统计学意义（P＜0．01）。治疗前两组患者血钠差异无统计学意义（t＝-0．8，P＞0．05）；两组患者治疗后均可提高血钠水平，观察组为（131．5±3．3） mmol/L，高于对照组患者（122．3±3．3） mmol/L，差异有统计学意义（t＝13．9，P＜0．01）；两组患者治疗前后组内比较差异均有统计学意义（P＜0．01）。结论全方位护理干预可有效改善慢性心力衰竭合并低钠血症患者的低钠情况，提高患者心功能。

Effect of the comprehensive nursing intervention on the prognosis of the patients with chronic heart failure and hyponatremia

Objective To explore the effect of the comprehensive nursing intervention on the prognosis of the patients with chronic heart failure and hyponatremia .Methods One hundred patients with chronic heart failure and hyponatremia from January 2011 to December 2013 in our hospital were chosen and divided into the control group and the observation group according to the random number table , each with 50 cases.All patients were given the routine medicine , and the control group received the routine nursing , and the observation group received the comprehensive nursing intervention for 4 weeks .The prognostic indicators including the level of serum sodium and cardiac function were compared between two groups .Results The total effective rate was 96.0%in the observation group , and was higher than 72.0% in the control group , and the difference was statistically significant （χ2 =10.7,P〈0.01）.The cardiac ultrasound indexes including the LVESD , LVEDD and LVEF%were respectively （43.3 ±6.9）mm,（53.4 ±5.0）mm,（53.8 ±8.5）%in the observation group, and were better than those of the control group , and the differences were statistically significant （ t =-4.0,-2.7,7.5, respectively;P〈0.01）.No difference was found in the level of serum sodium before the treatment between two groups （t=-0.8,P〉0.05）.The level of serum sodium was increased after the treatment in two groups, and was （131.5 ±3.3） mmol/L in the observation group, and was （122.3 ±3.3） mmol/L in the control group, and the difference was statistically significant （t=13.9,P〈0.01）.The difference was found within the group before and after the treatment in two groups （P〈0.01）.Conclusions The comprehensive nursing intervention can effectively improve the level of serum sodium in the patients with chronic heart failure and hyponatremia , and improve patients ’ cardiac function .