不同排便方式对急性心肌梗死早期患者心脏功能的影响

Effects of Different Body Positions during Defecation on the Cardiac Function in Patients with Acute Myocardial Infarction

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。

Objective To explore the effect of different body positions on the heart rate,blood pressure and myocardial oxygen consumption in patients with acute myocardial infarction（AMI） during the whole stage of defecation and to provide basis for clinical nursing of AMI patients to take reasonable and effective measures during defecation.Methods 50 patients with acute myocardial infarction were randomly divided into experimental group（n=25） with bedside chair during defecation and control group（n=25） with bed supine defecation.Multi-functional ECG monitor was used to record heart rate,blood pressure and myocardial oxygen consumption in the whole stage.Results There was no significant difference in heart rate between two groups in the whole defecation stage;blood pressure and myocardial oxygen consumption were with no statistical significance in calm state,preparation state,5 minutes and 30 minutes after finishing.But the blood pressure and myocardial oxygen consumption of control group were higher than those of experimental group during defecation（P0.05）.Conclusion Supine position can not control the increasing of heart rate,blood pressure and myocardial oxygen consumption effectively during defecation and the bedside chair seat stool during defecation is proved to be an alternative way for AMI patients without serious complications.