肺心病急性加重期部分床上活动对患者心肌耗氧量及血氧饱和度的影响

目的评价肺心病急性加重期部分床上活动对患者心肌耗氧量及血氧饱和度的影响。方法对100例肺心病急性加重期患者于入院两周内,在平静状态下,床上排便、排尿、探视、床上浴、进食及翻身、深呼吸和低强度下肢活动9个时间点应用心电监护仪监测血压、心率、呼吸及外周血氧饱和度(SpO2)并计算D-P值(心率与收缩压两项乘积用以表示心肌耗氧量)。结果床上排便、排尿、探视、床上浴活动D-P值增加显著,床上排便时D-P值最大。同样,床上排便、排尿、探视、床上浴及进食的SpO2下降明显,床上排便时的SpO2下降最明显,而翻身、深呼吸、低强度下肢活动时的D-P及SpO2无明显改变。结论在进行排便、排尿、探视、床上浴、进食时严密监测和观察,采取相应的护理措施,能降低心肌耗氧量、提高呼吸肌能力,减轻心脏负荷。同时适当进行低强度的下肢活动和深呼吸活动,定时翻身,防止潜在的、危险的并发症发生。

The Effect of Partial Bed Activity on Myocardial Oxygen Consumption and Oxygen Saturation in Patients with Acute Deteriorating Phase of Cor-Pulmonale

Objective To evaluate the effect of partial bed activity on myocardial oxygen consumption and oxygen saturation in patients with acute deteriorating phase of Cor-Pulmonale. Method To measure the D-P value in 100 cases of patients with acute deteriorating phase of Cor-Pulmonale within 2 weeks after their admission at 9 different time slot by bedside physiological monitor to monitor their blood pressure, heart rate, respiration rate and oxygen saturation during ： resting, bowel opening on bed, passing urine, visiting hour, bed bathing, feeding, turning position, deep breathing and lower limb exercise. Result A significant increase in D-P value during bowel opening on bed, passing urine, visiting hour, and bed bathing; with the biggest change of D-P value during bowel opening on bed. A significant decrease in SpO2 during bowel opening on bed, passing urine, visiting hour, bed bathing, and feeding. No obvious changes in both D-P value and SpO2 during turning position, deep breathing, lower limb exercise.Conclusion Close monitoring and appropriate nursing intervention during bowel opening on bed, passing urine, visiting hour, bed bathing, and feeding can reduce myocardial oxygen consumption, improve breathing muscle power, and reduce the cardiac workload. And carrying out lower limb exercise, deep breathing exercise and turning position regularly can reduce the potential risk of complications.