The protective effect of ischemic preconditioning occur in patients with acute myocardiac infarction

Ischemic preconditioning occur refers to the occurrence of many unstable angina pectoris before acute myocardial ischemia(AMI).It is generally recognized that ischemic preconditioning occur has protective effect on heart and can reduce infarction scope and improve contraction function of heart.Recently some authors whinks ischemic preconditioning occur will cause the exacerbation of patients‘ condition during the time of hospitalization and increase the incidence rate of angina and pectoris and death.OBJECTIVE:To explore the effect of ischemic preconditioning occur on prognosis of AMI.     

护理干预对脑梗死患者疗效及便秘症状的影响

目的 观察护理干预对脑梗死患者疗效及便秘症状的影响.方法 2009年10月至2010年10月,将我院98例脑梗死患者随机分为对照组和观察组各49例,对照组采用常规护理方法,观察组采用护理干预,比较观察2组的疗效和便秘症状变化.结果 2组治疗后ADL疗效评分明显升高,与治疗前比较差异显著.并且,观察组治疗后ADL疗效评分明显高于同期对照组.观察组排便困难、粪便性状、下坠感、排便频度和腹胀评分明显低于对照组.结论 对脑梗死患者实施护理干预,可明显改善患者的日常生活活动能力,提高临床疗效,改善便秘症状,值得临床参考应用.

Abstract：

Objective To observe the effect of nursing intervention on treatment effect and constipation symptoms of patients with brain infarction. Methods From October 2009 to October 2010, 98 cases patients with brain infarction were randomly classified into the control group and the observation group with 49 cases in each group. The control group was treated with normal nursing and the observation group received nursing intervention. The effect and the changes of constipation symptoms between the two groups were compared. Results Compared with pre-nursing, the scores of ADL in two groups were significantly improved after nursing. Moreover, the scores of ADL in the observation group were significantly higher than those in the control group. The scores of difficult defecation, characteristics of feces, feeling of bearing down was lower than those of the control group. Conclusions Nursing intervention for patients with brain infarction can improve the clinical effect and constipation symptoms, which can be applied in clinic.     

速度向量成像技术评价急性心肌梗死患者左心室不同步运动的临床研究

Objective To assess the left ventricular contraction asynchrony in patients with acute myocardial infarction(AMI) by velocity vector imaging(VVI).Methods Sixty AMI patients and 40 healthy volunteers were included.Using VVI,the time to peak longitudinal systolic velocity (TL-V) was measured in the left ventricular long axis views,the time to peak radial systolic velocity (TR-V) was measured in parasternal short axis views.The deviation of the earliest and the latest TL-V and TR-V (Ts max-min) was measured,and the standard deviation of TL-V and TR-V (TS-SD) was also measured.Results ①TL-V ,TR-V of the infarcted and non-infarcted segments in patients with acute myocardial infarction were longer than those of the normal segments (P ＜0.05).②The longitudinal Tsmax-min,Ts-SD and the radial Tsmax-min,Ts-SD in infarcted patients were increased compared with the healthy volunteers (P ＜0.001).③Ts of the infarcted segments was increased in turn from the class Ⅰ to class Ⅳ of the cardiac function (P ＜0.001).Conclusions VVI could be used to assess the left ventricular contraction asynchrony in patients with AMI.VVI is a new useful method to determine the infarcted segments.     

Arrhythmia and its risk factors post myocardial infarction:A prospective study

Objectives:To determine the occurrence of arrhythmia and its associated risk factors in the first week after acute myocardial infarction(MI).Methods:A total of 100 patients with acute MI were recruited,who were followed up for one week to determine the occurrence of arrhythmia and its association with electrolyte disturbances,left ventricular ejection fraction(LVEF),and demographic factors.Univariate and multivariate logistic regression was used to identify significant risk factors of arrhythmia.Results:Among 100 cases,arrhythmia was seen in 27 patients.Sinus tachycardia was the commonest,followed by ventricular premature beats and sinus bradycardia.Ejection fraction,serum calcium and magnesium were significantly different between non-arrhythmia and arrhythmia patients(P<0.05).Multivariate logistic regression analysis showed that ejection fraction was an independent significant risk factor of arrhythmia.Patients with ejection fraction>40%had a significantly lower risk of arrhythmia with an adjusted odds ratio of 0.22(95%CI:0.08 to 0.64).Conclusions:Arrhythmia is common in the first week after myocardial infarction.The type of arrhythmia and the type of block may depend on the heart muscles involved during myocardial infarction.Ejection fraction is a risk factor that may affect the occurrence of arrhythmia.     

The Effect of Psychologic Nursing on Post-stroke Depression

Some studies showed that post－ stroke depression(PSD) was closely related to the mental－ psychologic factors[1.98 PSD patients recepted the matched control method of effective factors, and 31 of those received the proper interference of psychologic nursing from 2000.10 to 2001. 2 in our hospital.Compared with the patients receiving routine nursing, the effect of interference was significant.1 Material and Method1.1 Subject The patients discharged before december of 2000 as routine nursing…     

依达拉奉对急性大面积脑梗死患者高敏C反应蛋白影响的临床研究

Objective To explore the effects of edaravone on high sensitivity C-reaction protein (hsCRP) in patients with acute massive cerebral infarction. Methods 86 cases with acute massive cerebral infarction were selected from December 2006 to December 2008. all the cases were divided into two groups, control group and cure group. routine treatment was used to the control group, on the basis of control group'therapy,edaravone was given to cure group. the level of hsCRP was detected before and after treatment, and the results of cure was compared. Results ①the total effective rate in two groups existed statistical difference (P<0.05);② the level of hsCRP in two groups before treatment and in the 7th and the 14th of treatment existed statistical difference(P<0.01), the level of hsCRP in the 7th and the 14th of treatment in cure group existed statistical difference(P<0.05). Conclusion Edaravone can decrease the level of hsCRP in patients with massive cerebral infarction, and has significant clinical efficacy,which should be the reference for the doctors.     

红细胞比容对急性心肌梗死患者预后的影响

Objective To examine the relationship between hematocrit and risk of long term mortality among patients with acute myocardial infarction. Methods A total of 274 patients with acute myocardial infarction were recruited and divided into two groups by death after long term follow-up, the relationship between hematocrit and mortality was evaluated through the methods of independent t-test,chi-square test and multivariate regression analysis. Results The mean age was 69. 79 ± 7.45 years, with 73. 0% of male. The average of followup was 44. 4± 10. 7 months, with mortality of 38.7% . Comparison of baseline data showed that NYHA classification, smoking history, hemoglobin, hematocrit, mean red cell volume, glomerular filtration rate, ejection fraction,left ventricular diastolic diameter and right ventricular diameter was significantly different between the two groups( Ps ＜ 0. 05), Multivariable logistic analysis showed that hematocrit ,glomerular filtration rate, ejection fraction and smoking history were independently predicted factors, with OR of 0. 904 (95% CI: 0. 832 - 0. 982,P =0. 016) ,0. 983 (95% CI: 0. 969 -0. 996,P =0. 014) ,0. 932 (95% CI: 0. 887 -0. 979,P =0. 005) and 3. 230 (95% CI: 1.468 - 7. 106, P = 0. 004), respectively. The power of hematocrit to predict mortality was examined by ROC curves, the area under the curve was 0. 669(P ＜ 0. 001,95% CI: 0. 603 - 0. 736) Conclusion Hematocrit is a significant independent predictor for long term death among patients with acute myocardial infarction.     

依达拉奉对急性大面积脑梗死患者高敏C反应蛋白影响的临床研究

Objective To explore the effects of edaravone on high sensitivity C-reaction protein (hsCRP) in patients with acute massive cerebral infarction. Methods 86 cases with acute massive cerebral infarction were selected from December 2006 to December 2008. all the cases were divided into two groups, control group and cure group. routine treatment was used to the control group, on the basis of control group'therapy,edaravone was given to cure group. the level of hsCRP was detected before and after treatment, and the results of cure was compared. Results ①the total effective rate in two groups existed statistical difference (P<0.05);② the level of hsCRP in two groups before treatment and in the 7th and the 14th of treatment existed statistical difference(P<0.01), the level of hsCRP in the 7th and the 14th of treatment in cure group existed statistical difference(P<0.05). Conclusion Edaravone can decrease the level of hsCRP in patients with massive cerebral infarction, and has significant clinical efficacy,which should be the reference for the doctors.     

不同时期急性心肌梗死的临床特点分析

目的 分析我院心脏中心8年来收治5720例急性心肌梗死(AMI)患者的临床特点和院内死亡原因.方法 2002年1月1日至2009年12月31日期间我院心脏中心收治AMI患者5720例.根据年龄分为≤45岁组、46～75岁组和＞75岁组,统计分析其发病率、死因、是否接受PCI介入治疗及接受介入治疗后的死亡情况以及性别对死因的影响.结果 2002-2009年不同年龄组AMI发病率男性均高于女性,＞75岁组女性发病率显著升高,但仍低于男性.所有AMI患者接受介入治疗的比例明显升高,接受介入治疗患者每年病死率明显下降.死亡原因前三位是急性心力衰竭、心源性休克及急性心力衰竭合并心源性休克,且在女性和＞75岁患者急性心力衰竭导致的死亡明显增加.结论 我院AMI住院人数逐年增加,接受介入治疗能降低病死率,＞75岁老年人血运重建治疗仍然是可行及安全的.

Abstract：

Objective The study aimed to analyze the clinical features and the causes of hospital death among the 5720 acute myocardial infarction(AMI)patients from Cardiology Center,Beijing Chao-Yang Hospital during the last 8 years. Methods A total of 5720 AMI patients received treatment in the Cardiology Center from January 1st ,2002 to December 31th ,2009 were retrospectively reviewed. All patients were classified according to age into 3 groups of ≤45,46 -75,and ＞ 75 years old. The morbidity,cause of death ,whether they had the PCI therapy,mortality after PCI and the impact of gender on the cause of death were observed respectively. Results The morbidity rate of male was significantly higher than female in all three groups,and the study also found that the morbidity rate of female was significantly higher in the group of ＞ 75 years old,which however was still lower than that of male. The AMI patients were more likely to accept PCI therapy,which could significantly reduce the mortality rate. The top 3 causes of death included acute heart failure(AHF),cardiogenic shock(CGS)and AHF combined with CGS. In addition,AHF caused significantly more death in female and older(＞ 75 years old)patients. Conclusions The morbidity rate of AMI patients in Beijing Chao-Yang Hospital increased year by year. And PCI therapy could reduce the mortality rate of all groups. Revascularization treatment seems to be feasible and safe for the patients older than 75 years old.     

叙事护理对乳腺癌患者术后焦虑抑郁情绪及病耻感的影响分析

【 】 Objective To analyze the influence of narrative nursing on the bad mood and stigma of breast cancer patients. Methods Taking August 2021 to August 2022 as the time line, 60 patients with breast cancer who underwent surgery in our hospital during this period were selected as the research object. According to the order of admission, the first 30 patients were classified as the control group, and the other 30 patients were classified as the experimental group. The control group was given routine nursing care, while the experimental group was given narrative nursing care, and the changes of adverse emotions between the two groups were compared. Results The nursing satisfaction of the experimental group was higher than that of the control group (P < 0.05). Before nursing, there was no difference between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Before nursing, there was no difference in the scores of anxiety and depression between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Conclusion Narrative nursing can effectively alleviate the anxiety and shame of breast cancer patients, which is worth applying.     

家庭护理干预对急性心肌梗死恢复期便秘的影响

目的探讨急性心肌梗死患者的家庭护理干预及其对降低恢复期间因便秘而诱发心肌梗死的影响。方法回顾性调查分析2007年1月至2012年1月间本院就诊的312例急性心肌梗死患者，以2010年1月为界划为对照组和干预组，对照组147例，干预组165例。每组按层次分别随机选择男70例和女20例。干预组对患者进行护理干预，包括饮食指导，便意的培养，排便方法指导，便时陪护，适当的药物治疗及心理护理。出院后继续进行电话随访指导，对照组仅给予常规医嘱，出院后未进行电话随访指导。记录两组患者恢复期间便秘的发生情况及因便秘而诱发心肌梗死的情况。结果干预组患者恢复期发生便秘11例，便时诱发心肌梗死共2例，对照组患者恢复期发生便秘23例，排便时诱发心肌梗死共7例，其中1人突发猝死。两组患者的便秘发生率比较差异有统计学意义（x2=5．22，P〈0．025）。患者因便秘诱发心肌梗死的发病率比较差异亦有统计学意义（x2=27．70，P〈0．005）。结论家庭护理干预能降低心肌梗死患者便秘的发生率及降低心肌梗死的再发危险性，提高急性心肌梗死患者的生活质量，并降低猝死率。     

中药敷脐结合穴位贴压解决心肌梗死患者便秘的效果观察

目的探讨中药敷脐结合穴位贴压解决心肌梗死患者便秘的效果。方法选择2011年6月～2012年6月本院收治的78例急性心肌梗死患者,将患者随机分为对照组40例和干预组38例,对照组患者给予常规护理,干预组在对照组基础上,给予中药敷脐结合穴位贴压。比较两组患者首次排便时间、大便性状以及排便后不良反应发生率。结果干预组患者首次排便时间较对照组明显缩短,大便性状明显改善,两组比较,均P〈0.05,差异具有统计学意义。两组患者在排便后半小时内均无出现心律失常、急性心力衰竭等并发症。结论中药敷脐结合穴位贴压能有效调节急性心肌梗死患者胃肠功能,有效解决患者便秘的发生。     

排便体位对急性心肌梗死早期患者心肌耗氧量的影响

目的明确排便体位对急性心肌梗死早期患者排便过程中不同时段心肌耗氧量的影响,为临床护士指导急性心肌梗死早期患者采取合理、有效的促排便措施,减少排便时严重并发症的发生提供依据。方法采用多功能心电监护仪,记录23例急性心肌梗死早期患者的25例次排便过程中的心率和血压,并比较两组患者排便过程中不同时段心率、血压及心肌耗氧量的变化。结果平卧位排便者与半卧位排便者在排便过程中各时段的心率、血压及心肌耗氧量差异均无统计学意义。结论平卧位排便并不能有效减少排便过程中心率、血压及心肌耗氧量的增加,半卧位排便也可考虑作为急性心肌梗死早期患者排便的一种合理选择。     

不同排便方式对急性心肌梗死早期患者心脏功能的影向

目的 探讨急性心肌梗死患者早期采取不同排便方式,对排便过程中不同时段心率、血压、心肌耗氧量的影响,为指导患者采取安全、有效的排便措施提供依据.方法 将50例急性心肌梗死早期患者随机分为观察组、对照组各25例,观察组采用床旁坐便椅坐位方式排便,对照组采取床上平卧位排便.使用多功能心电监护仪,记录两组排便过程中6个时段的心率和血压,计算心肌耗氧量,比较两组在6个时段3个指标的差异变化.结果 两组心率在排便各时段差异均无统计学意义;两组的血压、心肌耗氧量在平静状态、便前准备、便后整理、便后5 min、便后30 min差异无统计学意义,但对照组在排便中的血压、心肌耗氧量高于观察组(P＜0.05).结论 床上平卧位排便并不能有效减少排便过程中心率、血压及心肌耗氧量的增加;急性心肌梗死早期无严重并发症、血流动力学稳定的患者在床旁使用坐便椅坐位排便是一种相对安全、合理的选择.     

急救护理合理快捷供给模式在急性心梗患者中的应用观察

目的 观察急救护理合理快捷供给模式在急性心梗患者中的应用效果。方法　将2018年1至6月于我院接受常规急诊护理干预的急性心梗者54例设为对照组,2018年7至12月于我院接受急救护理快捷供给干预的急性心梗者54例设为试验组,对两组干预后的各观察指标进行比较。结果　试验组急性心梗者急救效果指标、急救时间和预后指标显著优于对照组,（P＜0.05）。结论　采用急救护理合理快捷供给模式对急性心梗患者施加干预,可显著提高急救时效性,改善预后。     

急性心肌梗死早期患者排便过程中心脏自律性的变化

目的探讨急性心肌梗死(acute myocardial infarction,AMI)早期患者排便过程不同时段心脏自律性的变化特点,为临床对AMI早期患者采取有效的护理措施减少排便并发症的发生提供依据。方法采用动态心电图仪连续记录23例AMI早期患者25例次排便过程中的十二导联心电图,观察并比较AMI早期患者排便过程中不同时段心率变异性(heart rate variability,HRV)、QT离散度等指标的变化。结果AMI早期患者排便过程的不同时段中,HRV变化无统计学差异;但校正后QT离散度在排便过程中升高明显(P<0.05)。结论排便对AMI早期患者心脏自律性负性影响较大,尤以便中前期和便后整理时最为明显;护理人员应加强排便过程中的心脏功能监护,缩短患者排便时间,积极协助患者做好便后整理工作。     

集束化护理预防急性心肌梗死病人便秘的效果观察

[目的]观察集束化护理预防急性心肌梗死病人便秘的效果。[方法]将80例急性心肌梗死接受住院治疗的病人随机分为对照组和观察组,每组40例,两组病人均给予24h心电监护并按医嘱进行治疗。对照组给予常规护理,观察组在常规护理的基础上给予集束化护理,在护理过程中观察并记录病人的腹胀程度、首次排便时间、排便总有效率和粪便性状。[结果]护理干预后观察组病人排便总有效率明显高于对照组(P0.05);观察组病人Bristol大便性状和大便次数评分均明显低于对照组(P0.05);观察组病人首次排便时间明显短于对照组,不良排便发生率明显低于对照组(P0.05)。[结论]对急性心肌梗死病人实施集束化护理可改善其便秘情况,缩短首次排便时间,降低腹胀发生率。     

穴位按摩联合腹部按摩预防急性心肌梗死病人便秘的临床研究

[目的]研究穴位按摩联合腹部按摩对预防急性心肌梗死(AMI)病人便秘的作用.[方法]将185例AMI病人,随机分为3组,A组(65例)给予穴位按摩、腹部按摩;B组(62例)给予腹部按摩;C组58例为空白对照组,观察3组病人的护理效果及A组、B组病人护理前后的血压、心率情况.[结果]3组病人有效率比较,均有统计学意义(P＜0.01);3组病人首次排便情况比较,A组明显优于B组、C组,B组优于C组.A组与B组护理前后的血压、心率比较无统计学意义(P＞0.05).[结论]穴位按摩联合腹部按摩预防AMI病人便秘安全有效.     

主动脉球囊反搏术后应用呼吸机辅助治疗急性心肌梗死合并心源性休克患者的护理

目的:探讨主动脉球囊反搏术后应用呼吸机辅助治疗急性心肌梗死合并心源性休克患者的效果及护理方法。方法:回顾分析我院21例急性心肌梗死合并心源性休克患者主动脉球囊反搏术后应用呼吸机辅助治疗的护理措施。结果:急性心肌梗死合并心源性休克患者经过积极的抢救治疗,16例患者好转出院,3例患者抢救无效死亡,2例患者家属签字放弃抢救,自动出院。救治成功率为76.19%。结论:急性心肌梗死患者应用主动脉球囊反搏治疗具有良好的近期疗效,及时使用呼吸机辅助治疗,给予积极有效的预防治疗护理措施,能降低死亡率,提高救治成功率,促进患者康复。     

个性化护理干预对心肌梗死急性期并发症的影响

目的:探讨个性化护理干预对心肌梗死急性期并发症的影响。方法:将86例急性心肌梗死患者按入院单双日随机分为实验组42例,对照组44例。两组均接受常规的治疗和护理,实验组还进行个性化护理干预。对两组患者急性期主要并发症心力衰竭、心律失常和心源性休克发生率,住院病死率及死亡原因进行对比分析。结果:对照组急性期主要并发症中心力衰竭的发生率明显高于实验组(P<0.05);对照组急性期住院病死率高于实验组(P<0.05);死亡的主要原因为心力衰竭,由于心力衰竭而导致对照组患者死亡情况明显多于实验组(P<0.05)。结论:个性化护理干预可降低急性心肌梗死患者急性期并发症的发生率及住院病死率。