部分活动对急性心肌梗死早期病人心肌耗氧量的影响

Effects of Activities on Myocardial Oxygen Consumption of the Patients with AMI in the Early Stage

目的评价部分活动对急性心肌梗死 (AMI)早期病人心肌耗氧量的影响。方法对 30例AMI病人于入院 72h内 ,在平静状态下、排便后、探视和查房后 ,以及进行低强度肢体活动和深呼吸运动后 6个时间点测量血压、心率 ,计算D P(心率与收缩压二项乘积 ,用以表示心肌耗氧量 )。结果在排便、探视、查房和低强度肢体活动后D P值增加显著 ,床上排便后D P值最大 ,而深呼吸运动后D P值无明显改变。结论AMI病人排便时D P值显著增加 ,发生各种心律失常、心肌破裂等的可能性增加 ,因此 ,必须有医护严密监护 ;在病情稳定的情况下 ,可进行适当的低强度肢体活动和深呼吸运动 ,以减轻病人的久卧不适感 ;尽量减少医护和家属不必要的频繁查房、探视 ,以减少心脏负荷 ,降低心肌耗氧量。

Objective To evaluate the effects of activities on myocardial oxygen consumption (MVO 2) of the patients with acute myocardial infarction (AMI) in the early stage. Methods Thirty patients with AMI, during the first 72 h of hospitalization, the results of blood pressure (BP) and heart rate (HR) were measured while at rest and after defecating, visiting, ward-round, low intensity activities and deep breathing. Then the result of double-product (D-P) was calculated using the formula: D-P=SBP×HR.Results D-P were increased after all activities. It was significantly higher after defecating, visiting, ward-round, and low intensity activities. Especially after defecating the D-P was the largest, while it did not change significantly after and deep breathing. Conclusion It is dangerous for patients to defecating, so close observation was needed. The patients can take some low intensity activities to release their discomfort on bed if being allowed. To decrease MVO 2 of the patients, healthcare providers and relatives should do ward-round or visit as few as possible.