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目的:观察规范化用药干预对慢性心力衰竭患者的效果。方法:选取275例心功能Ⅱ~Ⅳ级的慢性心力衰竭患者作为研究对象,随机分为干预组140例和对照组135例。干预组患者分别于入院时、住院期间、出院前、出院后第1,2,3个月6个时点,经过评估—制定方案—干预—再评估循环,评价2组患者在出院3个月后的干预效果。结果:干预组与对照组患者对疾病知识和用药依从性提高明显高于对照组(P<0.05);干预组临床不合理用药情况改善显著好于对照组(P<0.05)。血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)的使用率、达靶剂量率高于对照组(56.9%和29.2%;35.6%和16.4%,P<0.05),β受体阻滞剂使用率、达靶剂量率显著高于对照组(48.9%和29.2%,27.6%和16.4%,P<0.05),干预组较对照组患者用药依从性明显提高(干预组从来没有占95.7%~100%,对照组十分经常占31%~56%,P<0.05),干预组较对照组患者因心衰加重再入院率明显下降(16%和33%,P<0.05),2组死亡率无明显差异。结论:规范化用药干预能提高慢性心力衰竭患者有循证医学证据的药物治疗,提高患者用药依从性,降低再入院率。
Objective: To observe the effect of standardized medication intervention on patients with chronic heart failure. Methods: A total of 275 patients with chronic heart failure with grade Ⅱ ~ Ⅳ heart function were selected and randomly divided into intervention group (140 cases) and control group (135 cases). Intervention group patients were admitted to hospital, during hospitalization, before discharge, 1, 2, 3 months after discharge at 6 o’clock, after assessment - to develop programs - intervention - revaluation cycle, two groups were evaluated in the discharge of 3 months After the intervention effect. Results: The improvement of disease knowledge and medication adherence in intervention group and control group was significantly higher than that in control group (P <0.05). The improvement of clinical irrational medication in intervention group was significantly better than that in control group (P <0.05). The rate of target dose of angiotensin converting enzyme inhibitor / angiotensin Ⅱ receptor antagonist (ACEI / ARB) was higher than that of the control group (56.9% and 29.2%, 35.6% and 16.4%, P <0.05) , β receptor blockers utilization rate and target dose rate were significantly higher than those in the control group (48.9% vs 29.2%, 27.6% vs 16.4%, P <0.05), and the compliance rate of the intervention group was significantly higher than that of the control group Group had never accounted for 95.7% ~ 100% and control group accounted for 31% ~ 56% very often, P <0.05). The admission rate of intervention group was significantly lower than that of control group (16% and 33%, P < 0.05), no significant difference between the two groups mortality. Conclusion: Standardized medication intervention can improve the medical treatment of evidence-based medical evidence in patients with chronic heart failure, improve medication compliance and reduce the rate of re-admission.