急性心肌梗死患者排便意愿的调查研究(1)
摘 要：目的 了解急性心肌梗死患者住院期间的排便意愿，以便更好为患者提供优质护理服务提供依据。方法 采用问卷调查法对符合纳入标准的200例急性心肌梗死患者进行住院期间排便意愿的调查，最终获得195例有效问卷，采用自制排便意愿调查表进行调查。结果 参与调查的195例急性心肌梗死患者中，192例(98.46%)患者习惯蹲位或坐位的排便方式；在病情允许的情况下，急性心肌梗死患者中更倾向于选择入厕排便187人次(83.85%)，倾向于床旁入厕的共31人次(13.90%)；且112例(57.44%)患者认为床上排便的方式对自身影响很大，更有34例患者宁可不排便；131例(67.18%)有拒绝床上排便的想法，急性心肌梗死114人次(59.69%)是患者拒绝床上排便的主要原因排便习惯的改变。结论 床上排便方式给急性心肌梗死患者带来诸多不愉快的住院体验，大多数急性心肌梗死患者对于床旁或入厕排便有极大的意愿請求。在充分评估患者病情，妥善监护的基础上，医护人员应尊重患者的排便意愿及需求。
关键词：急性心肌梗死；排便；优质护理
, 百拇医药
中图分类号：R542.2+2；R195 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.033
文章编号：1006-1959(2018)20-0111-04
Abstract：Objective To understand the intention of defecation during hospitalization for patients with acute myocardial infarction in order to provide a basis for better quality care for patients.Methods A questionnaire survey was conducted to investigate the intention of defecation during hospitalization in 200 patients with acute myocardial infarction who met the inclusion criteria.Finally，195 valid questionnaires were obtained，and the self-made defecation willingness questionnaire was used for investigation.Results Of 195 patients with acute myocardial infarction，192(98.46%)were used to squatting or sitting.Among the patients with acute myocardial infarction，187(83.85%)patients tended to go to the toilet and 31(13.90%)patients tended to go to the toilet beside the bed，and 112 (57.44%)patients thought that the way of defecation in bed had a great effect on themselves，and 34 patients preferred not to defecate. 131 cases(67.18%)had the idea of refusing defecation in bed.114(59.69%)patients of acute myocardial infarction were the main reasons for the change of defecation habits.Conclusion Bed defecation has brought many unpleasant hospitalization experiences to patients with acute myocardial infarction.Most patients with acute myocardial infarction have great willingness to ask for bedside or toilet defecation.On the basis of fully assessing the patient's condition and proper supervision，the medical staff should respect the patient's willingness and needs for defecation.
, 百拇医药
Key words：Acute myocardial infarction；Defecation；High quality nursing
急性心肌梗死(acute myocardial infarction，AMI)是指由于冠状动脉急性狭窄或闭塞，供血持续减少或终止，所产生的心肌严重缺血和坏死。随着医学的发展，血运重建治疗日臻普及，急诊PCI能机械开通闭塞的冠状动脉，立即恢复心肌供血和再灌注，冠状动脉TIMI Ⅲ级血流可达85%～90%[1]。而目前我国AMI患者的早期活动及排便护理并未随医疗变革而改进。排便活动是威胁AMI早期患者生命安全的一大难题[2]。我国传统观念认为，AMI患者病情重、发作急，患者发生心肌梗死后越少活动越好，以降低心肌耗氧量和交感神经兴奋性。查阅国内近期关于AMI患者早期运动康复研究[3，4]，以及对北京市6所三级甲等医院冠心病监护室调研发现，现阶段我国大部分医院内AMI患者早期活动方案以循序渐进为原则，患者即使接受PCI等血流再灌注等手术后，所有患者均需绝对卧床3 d，AMI患者在卧床期间均采取床上排便的方法，以避免因体位改变增加心脏负荷，预防再梗死或猝死。而有研究表明：平卧位排便不仅不能减轻AMI早期患者的心脏负荷，反而增加了患者的不适感[5，6]。近些年来，大部分医院已将患者的住院体验作为为衡量医疗保健质量的一项重要指标。如何在保障安全的前提下，提高AMI患者的排便舒适感是目前面临的重要护理问题，而对患者排便情况进行评估，了解患者的排便习惯及排便方式，是进行针对性护理的前提。因此，本研究旨在调查AMI患者的排便意愿，为进一步制定护理措施，提高患者满意度提供依据。, 百拇医药(韩宇 朱丽丽 孙婷)
关键词：急性心肌梗死；排便；优质护理
, 百拇医药
中图分类号：R542.2+2；R195 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.033
文章编号：1006-1959(2018)20-0111-04
Abstract：Objective To understand the intention of defecation during hospitalization for patients with acute myocardial infarction in order to provide a basis for better quality care for patients.Methods A questionnaire survey was conducted to investigate the intention of defecation during hospitalization in 200 patients with acute myocardial infarction who met the inclusion criteria.Finally，195 valid questionnaires were obtained，and the self-made defecation willingness questionnaire was used for investigation.Results Of 195 patients with acute myocardial infarction，192(98.46%)were used to squatting or sitting.Among the patients with acute myocardial infarction，187(83.85%)patients tended to go to the toilet and 31(13.90%)patients tended to go to the toilet beside the bed，and 112 (57.44%)patients thought that the way of defecation in bed had a great effect on themselves，and 34 patients preferred not to defecate. 131 cases(67.18%)had the idea of refusing defecation in bed.114(59.69%)patients of acute myocardial infarction were the main reasons for the change of defecation habits.Conclusion Bed defecation has brought many unpleasant hospitalization experiences to patients with acute myocardial infarction.Most patients with acute myocardial infarction have great willingness to ask for bedside or toilet defecation.On the basis of fully assessing the patient's condition and proper supervision，the medical staff should respect the patient's willingness and needs for defecation.
, 百拇医药
Key words：Acute myocardial infarction；Defecation；High quality nursing
急性心肌梗死(acute myocardial infarction，AMI)是指由于冠状动脉急性狭窄或闭塞，供血持续减少或终止，所产生的心肌严重缺血和坏死。随着医学的发展，血运重建治疗日臻普及，急诊PCI能机械开通闭塞的冠状动脉，立即恢复心肌供血和再灌注，冠状动脉TIMI Ⅲ级血流可达85%～90%[1]。而目前我国AMI患者的早期活动及排便护理并未随医疗变革而改进。排便活动是威胁AMI早期患者生命安全的一大难题[2]。我国传统观念认为，AMI患者病情重、发作急，患者发生心肌梗死后越少活动越好，以降低心肌耗氧量和交感神经兴奋性。查阅国内近期关于AMI患者早期运动康复研究[3，4]，以及对北京市6所三级甲等医院冠心病监护室调研发现，现阶段我国大部分医院内AMI患者早期活动方案以循序渐进为原则，患者即使接受PCI等血流再灌注等手术后，所有患者均需绝对卧床3 d，AMI患者在卧床期间均采取床上排便的方法，以避免因体位改变增加心脏负荷，预防再梗死或猝死。而有研究表明：平卧位排便不仅不能减轻AMI早期患者的心脏负荷，反而增加了患者的不适感[5，6]。近些年来，大部分医院已将患者的住院体验作为为衡量医疗保健质量的一项重要指标。如何在保障安全的前提下，提高AMI患者的排便舒适感是目前面临的重要护理问题，而对患者排便情况进行评估，了解患者的排便习惯及排便方式，是进行针对性护理的前提。因此，本研究旨在调查AMI患者的排便意愿，为进一步制定护理措施，提高患者满意度提供依据。, 百拇医药(韩宇 朱丽丽 孙婷)