姿勢對氧合作用的影響及其臨床應用

The Effect of Body Position on Oxygenation and its Clinical Application

邊苗瑛(Mauo-Ying Bien) ； 王家弘(Jia-Horng Wang)

《中華民國物理治療學會雜誌》 13卷 (1988/09) Pp. 78-87

https://doi.org/10.29616/JPTAROC.198809.0012

摘要

不論是急性或慢性疾病患者，維持足夠的氧合作用均十分重要，近年來，有多篇研究報告指出，姿勢的改變會影響通氣在肺中的分佈，橫膈的收縮，動脈血氧分壓和肺及胸廓的順應性，而其影響及受到病患有無肺疾，此肺疾分佈的部位，手術與否及部位、年齡，肥胖與否及心臟功能等因素所改變。胸腔物理治療的姿勢引流及姿勢變換常被用於肺部積痰或咳嗽能力減低的病患，以保持其呼吸道通暢，避免感染及促進呼吸功能，由於有些病患在治療過程中，發生了心律不整的現象，使人懷疑姿勢引流是否對氧合作用有不良的影響？而文獻報告及作者的臨床觀察均發現，氧合作用的降低，都是發生於臥於壞側肺引流時，如果病人在姿勢引流後無痰或排出的痰較少者，平均PaO2有明顯的降低，而排出大量痰患者，PaO2無明顯改變。至於最引起關切的頭低引姿勢，並未引起氧合作用明顯降低的現象。本文在於探討各種身體姿勢對氧合作用的影響，並進一步討論如何在臨床上運用姿勢的改變，以增進病患的氧合作用。

並列摘要

Maintaining adequate oxygenation is very important to both acutely and chronically ill patients. Recently, many articles reported that positioning itself may affect gas distribution, diaphragmatic contraction, PaO2, and lung and thorax compliance. The entity and location of pulmonary dysfunction, type and Site of surgery, age, cardiac function and obesity may modify the effect of positioning on oxygenation. The chest physical therapy (CPT) techniques of postural drainage and positioning are frequently used in patients with retained secretions or decreased ability to cough in order to keep airway patency, prevent respiratory tract infection, and improve respiratory function. Because several patients developed arrhythmias during CPT, concerning the effect of this procedure on oxygenation has been raised. This paper reviewed the previous reports of the effect of various body positions on oxygenation and provided a ”sate of art” protocol for patient management.

並列關鍵字

Body position ； Oxygenation