急性心肌梗死心律失常的相关因素分析及护理对策

The Analysis of Related Factors of ArrhythmiaAfter Acute Myocardial Infarction and Its Nursing Method

目的 :探讨急性心肌梗死 (AMI)后影响心律失常的相关因素及护理对策。方法 :应用病例对照研究策略 ,对 12 3例急性心肌梗死后病人作心律失常与年龄、性别、情绪波动、伴高血压病和糖尿病、心力衰竭、休克、梗死部位、溶栓治疗、心肌酶、血脂、白细胞及死亡等可能的相关因素 ,在单因素分析的基础上应用Logistic回归多因素分析 ,以此结果为根据进行讨论。结果 :病例组有情绪波动、有心力衰竭和广泛前壁及下壁梗死 ,心律失常发病率分别是 5 3 5 %、6 0 6 %和 6 9% ,分别高于对照组的 2 5 %、30 8%和 4 4 2 % (χ2 分别为 5 72 9、3 994和 3 92 9,P分别为 0 0 17、0 0 4 6和 0 0 4 7) ,差异均有显著性。并得出OR分别为 3 2 87、2 6 15和 2 813,均大于 1,其 95 %可信区间分别为 1 2 4 0～ 8 711、1 0 18～ 6 714和 1 0 11～ 7 82 3,其内均不包含 1;而男性和溶栓治疗病例组心律失常发病率分别是 6 4 8%和 39 4 % ,分别低于对照组的 76 9%和86 5 % (χ2 分别是 5 6 0 0和 14 6 83,P分别为 0 0 18和 0 0 0 0 ) ,差异有显著性和非常显著性。并得出OR分别是 0 2 71和 0 116 ,均小于 1,其 95 %可信区间分别为 0 0 92～ 0 799和 0 0 39～ 0 349,其内均不包含 1。结论 :急性心肌梗死后 ,女性、?

Objective:To investigate the related factors of arrhythmia after acute myocardial infarction and the nursing method.Method:In 123 arrhythmia after acute myocardial infarction,their ages,sex,emotional change,hypertension,diabete,heart failure,shock,infarcted location,thrombolytic therapy,myocardic enzyme,blood fat,WBC and death were analyzed by logistic multifactor regression,then discussed them.Results:The morbidity of arrhythmia with emotional change,heart failure and infaction at extensive front wall and inferior wall was 53.5%,60.6% and 69% respectively in case group,which in control group was 25%,30.8% and 44.2% respectively,the difference was significant between them (χ 2=5.792,3.994,3.92;P=0.017,0.046,0.047 respectively).OR was 3.287>1,2.613>1 and 2.813>1 respectively,95% confidence interval was 1.240～8.711,1.018～6.714 and 1.011～7.823 respectively,which didn't include 1.The morbidity of arrhythmia of man and thrombolytic therapy cases was 64.8% and 39.4 respectively in case group,76.9% and 86.5% respectively in control group,and the difference showing statistical significance(χ 2=5.600,14.683;P=0.018 0.000 respectively).OR was 0.271<1 and 0.116<1 respectively,95% confidence interval was 0.092～0.799 and 0.039～0.349 respectively,which didn't include 1.Conclusion:The morbidity of arrhythmia after acute myocardial infarction increases in female,with emotional change,heart failure,extensive infarction at front and inferior wall,without thrombolytic therapy cases.The corresponding treatment and nursing methods should be recommended.