按脑钠肽水平进行心功能分级的护理干预对慢性心衰的疗效

目的：探讨根据血浆脑利钠肽（BNP）浓度，对老年慢性心力衰竭患者护理干预的临床意义。方法：选择80例老年慢性心力衰竭（CHF）患者，随机分为干预组和对照组，在常规治疗基础上，干预组根据血浆脑利钠肽（BNP）浓度进行心功能分级。两组分别于入院时和出院时测定血浆BNP水平、超声心动图测定左室射血分数；两组分别于出院时计算平均住院日。护理干预组分别于入院时进行合理休息与运动；饮食合理调配；保持大便通畅；适时的与家属沟通及心理护理。结果：两组患者入院时血浆BNP水平、LVEF比较无显著差异（P均〉0．05）。与对照组比较，出院时护理干预组血浆BNP水平明显降低（512．2±114．2）pg／ml：（426．8±136．2）pg／ml]，LVEF明显升高（43．63±10．23）％：（48．24±9．72）％]，平均住院日显著减少（20．38±8．23）d：（14．73±6．42）d]，P均〈0．05。结论：对老年慢性心力衰竭患者根据血浆BNP浓度，进行心功能分级，实施护理干预可改善心功能，提早出院。

Effect of nursing according serum brain natriuretic peptide level in aged patients with chronic heart failure

Objective： To explore the effect of nursing according serum brain natriuretic peptide level in the aged patients with chronic heart failure （CHF）. Methods： A total of 80 aged CHF patients were randomly assigned to intervention group （n=40） and control group （n=40）. Serum BNP and left ventricular ejection fraction （LVEF） were evaluated in both groups when the patients were admitted and discharged. Mean hospitalization time was calculated in both groups when the patients discharged. On the basis of regular therapy, the heart function of the patients in the intervention group were ranked according to the level of BNP and they accepted nursing including reasonable rest, exercise and food, avoiding constipation, communication with the family members at the right moment and psychological care. Resuits： When the patients admitted, there was no difference in serum BNP and LVEF in both groups. When the patients discharged, compared with the control group, the intervention group had lower serum BNP （512.2± 114.2） pg/ml ： （426.8±136.2） pg/ml], better LVEF （43.63±10.23）% ：（48. 24±9. 72）%] and shorter hospitalization time （20.38±8.23） d ： （14.73±6.42） d], P〈0.05 all. Conclusion： The aged CHF patients can benefit from nursing intervention when their heart function was ranked according to the level of BNP.