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目的探讨慢性心力衰竭反复发作的影响因素及防控措施。方法选取2014年1月至2015年6月在该院住院的慢性心力衰竭患者336例进行随访。从出院开始每月进行1次随访至心力衰竭复发终止,未复发者随访1年后终止;记录心力衰竭复发的诱因,收集患者受教育程度、前次住院心功能分级及家庭管控内容(服药依从性、日常饮食、是否吸烟、每日摄水量、是否坚持运动锻炼)等信息。结果 336例患者中8例因其他疾病或意外死亡,2例失访,最终326例纳入分析。感染、心律失常、心肌缺血为慢性心力衰竭复发的主要诱因。单因素分析显示,受教育程度低、服药依从性差、心功能差、吸烟、每日常摄水量>700 ml可增加慢性心力衰竭复发的风险,而低盐低脂饮食、坚持运动锻炼可降低慢性心力衰竭复发的风险,差异均有统计学意义(均P<0.05)。将服药依从性、心功能分级、日常饮食、吸烟、每日常摄水量纳入多因素Logistic回归分析模型,结果显示心功能差、吸烟、每日摄水量>700ml是心力衰竭复发的独立危险因素,坚持服药、低盐低脂饮食是心力衰竭复发的保护因素。结论应重视家庭管控对预防慢性心力衰竭反复发作的作用,对前次住院心功能差的患者应给予重视,从而在根本上降低病情反复发作的风险。
Objective To study the influential factors and prevention and control measures of recurrent chronic heart failure. Methods 336 patients with chronic heart failure admitted to our hospital from January 2014 to June 2015 were followed up. From the discharge began once a month for follow-up to terminate the recurrence of heart failure, non-recurrence were followed up for 1 year after the termination of the record of the recurrence of heart failure incentives to collect patient education level, the last hospitalized heart function classification and family control content Sex, daily diet, smoking, daily water intake, exercise or not). RESULTS: Of the 336 patients, 8 were fatal due to other diseases or accidents, 2 were lost to follow-up and 326 were finally included in the analysis. Infection, arrhythmia, myocardial ischemia as the main cause of recurrent chronic heart failure. Univariate analysis showed that low education, poor medication compliance, poor heart function, smoking, daily intake of water> 700 ml can increase the risk of recurrent chronic heart failure, and low salt and low fat diet, insist on exercise can reduce chronic heart failure The risk of recurrence of failure, the difference was statistically significant (P <0.05). Taking medication adherence, heart function grading, daily diet, smoking and daily routine water intake into the multivariate logistic regression model, the results showed that poor heart function, smoking, daily water intake> 700ml was an independent risk factor for recurrence of heart failure, Medication, low-salt low-fat diet is a protective factor of heart failure recurrence. Conclusions Should pay attention to the family control on the prevention of recurrent episodes of chronic heart failure, the last hospitalized patients with poor heart function should be given priority to fundamentally reduce the risk of recurrent illness.