| Objective: Chronic heart failure(CHF)is a complex clinical syndrome,which is caused by a variety of causes of cardiac function damage of chronic non-communicable diseases.Heart failure(HF)is the last battleground in the prevention and control of various cardiovascular diseases.To date,the prevalence of cardiovascular diseases in China remains high.Despite advances in the treatment and management of heart failure and the risk factors associated with heart failure,chronic heart failure remains a major public health problem.The prognosis of patients with heart failure is more and more complicated due to the uncertainty of the development of the disease.Therefore,the treatment effect of patients not only depends on the severity of the disease,but also requires valuable treatment programs and high-quality chronic disease management.Capacity overload is an important pathophysiological process in the development of acute and chronic heart failure.Is a major cause of hospitalization in patients with heart failure.Despite the importance of control capacity overload in the treatment of heart failure,there is still a lack of prospective studies on capacity management in heart failure.But today many grass-roots hospitals and community understanding of the disease of chronic heart failure is not enough,it is not able to make some effective measures to early detection of elderly patients with heart failure and to its individualized intervention,and one of the old patients with chronic heart failure of capacity management is more complex,more easy to ignore,and difficult to implement,patients with poor compliance.Methods: In this study,100 cases of patients with chronic heart failure were screened through physical examination and randomly divided into intervention group and control group with 50 cases each.Prior to the study,the patient's consent and informed consent were obtained.Patients were given basic information collection,including 6min walking test,Minnesota living with heart failure questionnaire(MLHFQ)and self-care index scale of psychological failure.The management team is mainly composed of general practitioners from hansenzhai community health service center,chronic disease management specialist,physical examination management specialist for the elderly,and under the guidance of cardiology specialists in tertiary hospitals,the patients are managed together.According to the different conditions of the patients in the intervention group,the individualized volume management program was developed under the recommendation of the cardiology specialist in the tertiary hospital,and the medication guidance for heart failure was given.These include: 1)water restriction;2)salt restriction;3)use of diuretics;4)control of body mass and ask patients to exercise moderately.Special intervention was given to the intervention group,including 1)free distribution of 200 ml water cups;2)free food diary;3)use special methods to urge the use of drugs;4)forming a heart failure support group to facilitate communication and communication.Both the intervention and control groups underwent general chronic disease management,including physical examination,followup and health education.The data were statistically analyzed by Excel and SPSS software.Results: In this study,a total of 100 patients with heart failure were recruited and randomly divided into the intervention group(50 patients)and the control group(50 patients),among whom 87 patients completed the whole process of the project.There were no significant differences between the two groups in terms of name,age,BMI,left and right diastolic blood pressure,systolic blood pressure,hemoglobin value,6min walking test,ECG,chest radiograph,left ventricular ejection fraction(LVEF),etc.(P > 0.05).In this study,after 8 months of management,the left mean systolic blood pressure and the right mean diastolic blood pressure decreased by 5.819 mm Hg and 1.767 mm Hg,respectively,and the right mean systolic blood pressure and the right mean diastolic blood pressure decreased by 3.019 mm Hg and 2.437 mm Hg,respectively,with statistically significant differences(P < 0.05).In the intervention group,the 6min walking test increased to 444.57±48.25 m,the LVEF value increased to 56.75±6.38%,and the hemoglobin value increased to 134.52±11.59g/L.The difference was statistically significant(P < 0.05).In the control group,the 6min walking test increased to 426.26±39.00 m,and the LVEF increased to 52.19±6.19%,with statistically significant difference(P < 0.05).The selfmanagement scale of heart failure increased to 50.61±4.02,T =17.302,P=0.000 in the intervention group,and decreased to 50.92±8.34,T =3.129,P=0.004 in the Minnesota scale,and increased to 47.40±3.06,T =9.814,P=0.000 in the control group,with statistically significant differences.Normal lower limb edema increased from 11 to 23 in the intervention group,P=0.000;normal electrocardiogram increased from 28 to 35,P=0.025;normal breathing increased from 16 to 24 in the intervention group,P=0.008;normal lower limb edema increased from 6 to 12 in the control group,P=0.031,and the difference was statistically significant.After 8 months of management,the data of the two groups were compared,and P values of blood pressure were < 0.05,with statistically significant differences.The 6min walking intervention group was 455.57±48.25 m,and the control group was 426.26±39.00 m,t=2.944,P=0.045,the difference was statistically significant.LVEF value was 56.75±6.38% in the intervention group and 52.19±6.19% in the control group,t=3.387,P=0.001,the difference was statistically significant.The hemoglobin value was 127.41±12.84g/L in the intervention group and 134.52±11.59g/L in the control group,t=2.593,P=0.013,and the difference was statistically significant.Heart failure selfmanagement scale intervention group was 50.61±4.02,control group was 47.40±3.06,T =4.194,P=0.000,Minnesota scale intervention group was 50.92±6.30,control group was 57.13±2.26,T =3.372,P=0.001,the differences were statistically significant.There were 23 patients in the normal intervention group and 12 in the control group,with t=3.372,P=0.020,and the difference was statistically significant.Conclusions: The capacity management model of chronic heart failure can help patients reduce blood pressure and increase the tolerance of the heart.Meanwhile,it can increase the selfmanagement ability and compliance of patients with heart failure,so as to improve the quality of life and increase the happiness of patients. |
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