目的 探讨可共享临床决策支持系统（clinical decision support systems,CDSS）在心力衰竭患者护理中的应用价值。方法 采用便利抽样法,选取2019年3月—2021年3月北京市某三级甲等医院收治的106例慢性心力衰竭患者为研究对象,按照入院时间分为试验组（2020年3月—2021年3月）和对照组（2019年3月—2020年2月）各53例。试验组接受基于可共享CDSS的护理干预,对照组接受常规护理干预。连续干预6个月后,比较两组的心功能、治疗依从性、自我护理能力及生活质量。结果 干预后,试验组的左室射血分数、每搏输出量、6 min步行试验水平高于对照组,左室舒张末期内径小于对照组（P<0.05）。试验组的治疗总依从率为90.57%,高于对照组的75.47%（χ2=4.283,P<0.05）。干预后试验组的自我护理能力量表（Exercise of Self-Care Agency Scale,ESCA）、明尼苏达心力衰竭生活质量问卷（Minnesota Living Heart Failure Questionnaire,MLHFQ）各项评分及总分均高于对照组（P<0.05）。结论 在心力衰竭患者的护理干预中应用可共享CDSS,有助于改善患者心功能、提升治疗依从性及自我护理能力,从而改善患者生活质量。
Objective To explore the application value of shareable clinical decision support systems（CDSS） in the care of patients with heart failure. Methods 106 patients with chronic heart failure who were admitted to a tertiary grade A hospital in Beijing from March 2019 to March 2021 were selected as the study subjects by convenience sampling method. They were divided into experimental group（from March 2020 to March 2021） and control group（from March 2019 to February 2020） according to the time of admission,with 53 cases in each group. The experimental group received nursing intervention based on shareable CDSS,and the control group received routine nursing. After 6 months of intervention,cardiac function,treatment compliance,self-care ability,quality of life of the two groups were compared. Results After intervention,left ventricular ejection fraction,stroke volume and 6-minute walking distance of experimental group were higher/longer than those of control group,and left ventricular end-diastolic diameter was smaller than that of control group（all P<0.05）. The total treatment compliance rate in experimental group was higher than that in control group（90.57% vs 75.47%）（χ2=4.283,P<0.05）. After intervention,the Exercise of Self-Care Agency Scale（ESCA） scores and the Minnesota Living Heart Failure Questionnaire（MLHFQ） scores of experimental group were significantly higher than those of control group（P<0.05）. Conclusion Applying shareable CDSS to the nursing of patients with heart failure is beneficial to improve cardiac function,treatment compliance and self-care ability of the patients,thereby improving quality of life.
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