不同操作方法半卧位对急性心肌梗死早期患者心电图的影响

Effects of Different Implementation Methods of Semi-recumbent on Cardiac Electrophysiology in the Early Stage Patients of Acute Myocardial Infarction

目的观察不同操作方法半卧位对急性心肌梗死早期患者心电图的影响,探索适合此类患者的最佳半卧位操作方法。方法便利抽样选择入住我院CCU且发病12~24h的急性心肌梗死患者28例,随机分为A组和B组,分别实施逐级抬高至半卧位和一步抬高至半卧位,观察并记录两组患者心率变异性（heart rate variability,HRV）指标：R-R间期标准差（standard diviation of normal to normal intervals,SDNN）、相邻RR间期差值均方的平方根（root mean square of successive difleremes,RMssD）;QT间期离散度指标：QT离散度（QT dispersion,QTd）及校正后的QT离散度（heart-corrected QT dispersion,QTcd）。结果不同操作方法半卧位时,两组患者SDNN、RMSSD、QTD、QTcd的改变幅度,逐级半卧位组为（3.34±1.05）、（2.14±1.96）、（2.4±1.03）、（3.21±1.02）ms,小于直接半卧位组的（5.98±2.07）、（4.23±1.87）、（4.4±1.92）、（4.57±1.91）ms,差异均有统计学意义（均P〈0.05）。结论从心脏电生理角度而言,逐级半卧位实施法优于直接半卧位实施法,值得临床推广应用。

Objective To observe the different implementation methods semi-recumbent patients with acute myocardial infarction cardiac electrophysiology,exploring semi-recumbent implementation method suits these patients.Methods CCU and the incidence of 1 2-2 4 h 2 8 patients with acute myocardial infarc-tion were randomly divided into group A and group B,and implement step by step semi-recumbent and direct semi-recumbent respectively.The heart rate variability,standard deviation of normal to normal in-tervals,root mean square of successive differences,QT dispersion and heart-corrected QT dispersion were observed and recorded.Results The implementation of different methods of semi-recumbent posi-tion,the SDNN,RMSSD,QTD,QTcd of two groups of patients were changed,step by step semi-recum-bent group [（3.34±1.05）ms,（2.14±1.96）ms,（2.4±1.03）ms,（3.21±1.02）ms]were less than direct semi-recumbent group [（5.98±2.07）ms,（4.23±1.87）ms,（4.4±1.92）ms,（4.57±1.91） ms],the difference was statistically significant （all P〈0 .0 5 ）.Conclusion The step by step semi-re-cumbent method was better than direct semi-recumbent method on the cardiac electrophysiology per-spective,and it’s worth for clinical trial.