| Objective To analyze the management of patients in the First people’s Hospital of Tonglu County with chronic heart failure based on wireless physiological monitor system,in order to reduce the chronic heart failure patients readmission.Method During April 2016 to April 2017,80 patients with chronic heart failure who left the First people’s Hospital of Tonglu County were admitted in this study.Dividing them into two groups which are control group which with standard follow-up examined methods as ST group and the observed group which with new method of wireless physiological monitor system as NST group.Patients in NST group wear the wireless physiological monitor system once a week to record heart rate,blood pressure and weight.According the system data,If any unusual condition happened proper treatments would be taken including health lessons,limitation of natrium and water,weight control,keeping warm,and reducing labor strength.At the same time proper medical treatments would be taken such as angiotensin converting enzyme inhibitor(ACEI),angiotensin II receptor antagonist(ARB),β-blocker,aldosterone receptor antagonists.The ST group would take regular medical visits once a month.We explored the risk of hospital re-admission of these two groups in three months.Results(1)P value of NST and ST groups on ACEI/ARB,β-blocker,aldosterone receptor antagonists is 0.617,0.363 and 1.000 which are higher than 0.05,which means the ratio difference on maximum tolerance dose(MTD)has no statistical sense.3 months after leaving hospital,P value of NST and ST groups on ACEI/ARB,β-blocker,aldosterone receptor antagonists is<0.01,<0.01 and 0.456 which are less than 0.05,which means MTD after three-month leaving hospital has statistical sense.38 patients of NST group reached MTD on ACEI/ARB after three-month leaving hospital,while 13 patients of ST group did.35 patients of NST group reached MTD on β-blocker after three-month leaving hospital,while 10 patients of ST group did.For aldosterone receptor antagonists there is no difference between NST and ST groups.The result shows that by wireless physiological monitor system,medical care can be adjusted in time and get better optimized.NST group reaches target density or maximum tolerance dose(MTD)faster and better than of ST group.(2)NYHA degree of both groups has P value of 0.795,which means it has no statistical sense.After three months leaving hospital,NYHA degree of both groups has P value of 0.004(<0.05),which means it has statistical sense.Degree Ⅲ and degreeⅣ of NYHA decrease significantly from NST group to ST group.(3)Minnesota Living with Heart Questionnaire(MLHFQ)is used to judge life quality of NST&ST groups.Score of ST group before follow-up checking is 53.63+6.74,and score of NST group before follow-up checking is 53.65+-7.63.P value is 0.987(>0.05)which means no statistical sense.Score of ST group after three-month leaving hospital is 49.625+-5.59,and score of NST group after leaving hospital is 31.52+-6.12.P value is less than 0.05 which means statistical sense.Decrease of NST group on score is significant,which decrease of ST group on score is not.(4)Re-admission rate after three-month leaving hospital of NST and ST group has a P value of 0.013(<0.05),which means the difference on re-admission rate has statistical sense.Six patients of ST group were re-admission once and two patients were twice(Readmitted rate is 20%).The same time one patient of NST group was rehospitalizedonce(Readmitted rate is 2.5%).The rehospitalization rate of NST group is significant lower than of ST group and the difference has statistical sense(P<0.05).Conclusions The management of patients with chronic heart failure based on wireless physiological monitor system was considered helpful in improving heart function as well as life quality of patients,leading to reducing hospital re-admission and solving the financial and social problems. |
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