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。

Cardiac Automaticity during Defecation at Early Stage of Patients with Acute Myocardial Infarction

Objective To investigate the change of cardiac automaticity during defecation at early stage of patients with acute myocardial infarction(AMI),so as to provide evidence for nursing of AMI patients and for reducing complication during defecation.Methods Dynamic electrocardiograph was used to ob- serve the changes of QT dispersion and heart rate variability during different periods in defecation(25 times)in 23 AMI patients.Results There was no significant change in heart rate variability during defe- cation at early stage of patients with AMI;QT dispersion was significantly raised(P<0.05,P= 0.047)during defecation.Conclusion The process of defecation,especially at the beginning and post-de- fection,has negative effects on heart autorhythmicity at early stage of AMI patients.Nurses should put more emphasis on dynamic monitoring of heart during defecation.Efforts should be made to reduce the defecation time and assistance should be given to patients timely after defecation.