不同体位干预对AMI早期患者心脏电生理、胃肠道不适的影响

doi:10.3969/j.issn.10073205.2017.08.004

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨不同体位干预对急性心肌梗死（acute myocardial infarction,AMI）患者心脏电生理、胃肠道功能的影响。
〖HTH〗方法〖HTSS〗〖KG*2〗以护理时间节点为分组依据，将104例AMI患者分为对照组（常规30 °平卧位）及研究组（阶梯式半卧位）各52例，以平卧位（t0）、刚调整至预定角度时半卧位(t1)、半卧位1 min(t2)、半卧位5 min(t3)、半卧位10 min(t4），比较2组患者不同时间段的心肌耗氧量、心率变异性、QT离散度(QT dispersion,QTd)以及胃肠道反应等。
〖HTH〗结果〖HTSS〗〖KG*2〗2组心肌耗氧量在t1时均明显升高，t2~t4呈逐渐下降趋势，但研究组下降更多；2组窦性心率间期标准差（standard diviation of NN intervals,SDNN）及相邻心动间期差值的均方根（square root of the mean squared differences of successive NN intervals,RMSSD）t2~t4均呈逐渐降低趋势，但研究组降低较少；2组ΔQTd和ΔQTcd从t2~t4均呈逐渐降低趋势，但研究组在t0时ΔQTd和ΔQTcd就低，故研究组下降幅度较小较平稳；2组以上指标在组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜005）。研究组腹胀及嗳气发生例数少于对照组，肠蠕动增加和3 d内首次排便例数则多于对照组，首次排便时间及排便用时少于对照组，差异均有统计学意义（P＜005）；研究组出现便秘、排尿困难例数以及视觉模拟评分法(visual analogue scale,VAS)、汉密尔顿焦虑量表（Hamilton anxiety scale,HAMA）得分少于对照组，差异均有统计学意义（P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗采用阶梯式半卧位有助于减少AMI早期患者心肌耗氧量，降低患者出现胃肠道不适及其他并发症发生率，从而利于患者康复。

关键词: 心肌梗死, 体位护理, 心脏电生理学, 胃肠道反应

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the effects of different postural intervention on cardiac electrophysiology and gastrointestinal function in patients with acute myocardial infarction(AMI).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and four patients with acute myocardial infarction who were treated were divided into control group(conventional 30 ° supine position) and study group(ladder semirecumbent position) . The differences of myocardial oxygen consumption, heart rate variability, QT dispersion(QTd) and gastrointestinal reaction were compared between the two groups in the supine position(t0), just to adjust semirecumbent predetermined angle(t1), semirecumbent 1min(t2), semirecumbent 5 min(t3), semirecumbent 10 min(t4).
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The myocardial oxygen consumption in group 2 was significantly increased from t1 to t4, but was decreased more in the study group. The standard diviation of NN intervals(SDNN) and the square root of the mean squared difference of successive of NN intervals from t2 to t4 and the study group were decreased less. The ΔQTd and ΔQTcd of the two groups were decreased gradually from t2 to t4, but the study group had lower ΔQTd and ΔQTcd at t0, so the decrease of the study group was smaller and more stable. There were significant differences in the intergroup, interpoint and intergroup interaction between time points between the two groups(P<0.05). The patients in the study group had less abdominal distension and belching than the control group, and the increase of bowel movements and the number of first defecation in 3 days were more than that in the control group. The first defecation time and defecation were shorter than the control group, the difference was statistically significant(P<0.05). The numbers in study group showed constipation, difficulty in urinating and visual analogue scale(VAS), Hamilton anxiety scale(HAMA) were lower than those of the control group, the difference was statistically significant(P<0.05). 〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The use of ladder semirecumbent helps to reduce early AMI myocardial oxygen consumption, reduce the incidence of gastrointestinal discomfort and other complications, so as to facilitate rehabilitation of patients.

Key words: myocardial infarction； cardiac electrophysiology, position nursing, gastrointestinal reactions

谢雪梅，张〓娟，马秀兰，庄〓瑜. 不同体位干预对AMI早期患者心脏电生理、胃肠道不适的影响[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2017.08.004.

XIE Xuemei, ZHANG Juan, MA Xiulan, ZHUANG Yu. Effects of different position intervention on cardiac electrophysiology, gastrointestinal function in AMI early patients#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2017.08.004.

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不同体位干预对AMI早期患者心脏电生理、胃肠道不适的影响

Effects of different position intervention on cardiac electrophysiology, gastrointestinal function in AMI early patients#br#

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