刘青香

【摘要】 目的：探讨循证护理干预对重症风湿性心脏瓣膜病患者术后的影响。方法：选取笔者所在医院2017年2月-2019年2月收治的136例行心脏瓣膜置换术的重症风湿性心脏瓣膜病患者为研究对象，将其随机均分为两组，常规组采用传统护理措施，研究采用循证护理措施，对比两组各项生理指标的差异。结果： 研究组护理后左心室射血分数高于常规组，左室舒张末期内径及心胸比均低于常规组，差异均有统计学意义（P<0.05）;研究组并发症发生率低于常规组，研究组术后精神障碍发生率、复发率均低于常规组，恢复正常时长短于常规组，差异均有统计学意义（P<0.05）。结论：重症风湿性心脏瓣膜病患者应用循证护理措施，可有效改善患者心功能指标，降低并发症发生率，使患者病情得到更好的恢复，值得推广应用。

【关键词】 循证护理 重症风湿性心脏瓣膜病 术后影响

doi：10.14033/j.cnki.cfmr.2020.18.043 文献标识码 B 文章编号 1674-6805（2020）18-0-03

Influence of Evidence-based Nursing on Postoperative Patients with Severe Rheumatic Heart Valve Disease/LIU Qingxiang. //Chinese and Foreign Medical Research， 2020， 18（18）： -104

[Abstract] Objective： To investigate the effect of evidence-based nursing intervention on postoperative patients with severe rheumatic heart valve disease. Method： A total of 136 patients with severe rheumatic heart valve disease who underwent heart valve replacement in our hospital from February 2017 to February 2019 were selected as the research objects， and they were randomly divided into two groups. The conventional group was given traditional nursing measures， the study group was given evidence-based nursing measures， the differences of physiological indexes between the two groups were compared. Result： After nursing， the left ventricular ejection fraction in the study group was higher than that in the conventional group， the left ventricular end-diastolic diameter and cardiothoracic ratio were lower than those in the conventional group， the differences were statistically significant （P<0.05）. The incidence of complications in the study group was lower than that in the conventional group， the incidence of postoperative mental disorders and recurrence rates in the study group were lower than that in the conventional group， and the length of return to normal was longer than that in the conventional group， the differences were statistically significant （P<0.05）. Conclusion： The application of evidence-based nursing measures in patients with severe rheumatic heart valve disease can effectively improve the cardiac function indicators of patients， reduce the incidence of complications， so as to better recover the patients condition， which is worthy of popularization and application.

[Key words] Evidence-based nursing Severe rheumatic heart valve disease Postoperative impact

First-authors address： Qilu Hospital of Shandong University， Jinan 250000， China

风湿性心脏瓣膜病属于极为多见的后天性心脏病种类，风湿活动会加重患者病情的严重性，其临床表现主要为呼吸急促、剧烈运动后心乱、头昏和咳嗽，严重者会伴有晕倒、腹水及咳血等状况，发病严重后会出现心功能衰竭，严重甚至导致患者死亡[1-2]。本研究对笔者所在医院收治的136例重症心脏瓣膜置换術患者展开研究，现将结果汇报如下。

1 资料与方法

1.1 一般资料

选取2017年2月-2019年2月在笔者所在医院行心脏瓣膜置换术的136例重症风湿性心脏瓣膜病患者为研究对象。纳入标准：患者正在康复期，病情并无剧烈波动，较为稳定。排除标准：患者语言表达能力存在问题，无法与研究人员进行正常交流;患有严重心、肝、肾等内科疾病，内脏功能存在异常。按照随机数字表法将其均分为两组，每组68例。常规组男36例，女32例，平均年龄（46.38±2.62）岁;平均心胸比（67.45±4.32）%。研究组男38例，女30例，平均年龄（47.50±2.14）岁;平均心胸比（68.44±3.97）%。……