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。

Effect of family nursing intervention on constipation of patients with acute myocardial infarction

Objective To investigate the effect of family nursing intervention on constipation of patients with acute myocardial infarction. Methods Totally 312 patients with acute myocardial infarction were investigated retrospectively in our hospital from January 2007 to January 2012. The patients were divided into two groups according to the date which was January 2010： the observation group （n = 147 ） and the control group （n = 165 ） . In each group, 70 male patients and 20 female patients were selected randomly. The observation group was given nursing intervention including food guidance, cultivating the awareness of defecation, method of defecation, defecation attendance, proper medicine and psychological treatment. To give patients telephone guidance even after they had left hospital. The control group was given routine nursing. The constipation rate and the myocardial infarction rate caused by constipation were recorded. Results There were 11 patients of constipation happened in the observation group , and 2 patients had myocardial infarction induced by constipation. In the control group there were 23 patients happened constipation and 7 patients had myocardial infarction , and 1 patient died because of myocardial infarction. There were statistics differences between the two groups in the rate of constipation （X2 = 5.22, P 〈 0. 025 ） and in the rate of myocardial infarction induced by constipation （X2 = 27.70, P 〈 0. 005 ） . Conclusions Family nursing intervention can reduce the constipation rate of acute myocardial infarction patients and reduce the recur rate of acute myocardial infarction, it can increase patients’ life quality and reduce the rate of sudden death.