急性心肌梗死患者发病早期进行部分自我护理活动的研究

目的确定急性心肌梗死（AM1）患者能否在发病的最早期（发病后24-72h）实行部分自我护理活动及活动的安全性。方法将55例符合入选条件的急性心肌梗死患者随机分为观察组与对照组，分别采取发病后24～72h进行部分自我护理活动和传统卧床休息的护理方法，观察患者心率、血压及心肌耗氧量等指标变化。结果两组在静息时、进食后、小便后、洗漱后心率、收缩压、舒张压、心肌耗氧量差异无统计学意义（P〉0．05）；观察组的再梗死、梗死后心绞痛等并发症发生率以及死亡率与对照组差异无统计学意义（P〉0．05），而便秘、坠积性肺炎等其他并发症发生率低于对照组（P〈0．05）；观察组平均住院天数少于对照组（P〈0．05）。结论对生命体征稳定、无严重并发症的急性心肌梗死患者梗塞24-72h在心电、血压监测下，早期实行自我护理活动不仅是安全可行的，而且有利于减少并发症，缩短住院天数。

Study on Partial Self-care Activities at Early Myocardial Infarction

Objective To explore the safety of partial self-care activities in patients with early myocardial infarction （AMI）. Methods 55 AMI patients were randomized into observation group and control group during 24-72 hours after the onset. In the observation group, some self-care activities were used and the controls were eared with conventional lying-bed. The indexes in heart rate, systolic pressure and diastolic pressure and myocardial oxygen consumption were compared. Results There were no significant differences in HR, SBP, DBP and D-P between the two groups at resting and after meals, urination and even bathing （P〉0.05）, and so it was with the two groups in terms of re-infarction, infarction-induced angina peetoris and mortality （P〉0.05）. The observation group was significantly lower than the control group in constipation and hypostatie pneumonia （P〈0.05）. The average hospitalization duration of the observation group was shorter than that of the control group （P〈0.05）. Conclusion For AMI patients with stable vital signs and no severe complications udner ECG and blood pressure monitoring at the first 24-72 hours, early self-care is safe and workable. Moreover, it is beneficial for reducing complications and shortening the duration of hospitalization.