- 學位論文
接受高壓氧治療的受試者其心率和血壓的變化：回溯性研究
Changes in heart rate and blood pressure of subjects receiving hyperbaric oxygen therapy:A retrospective study
摘要
前言：高壓氧治療 (hyperbaric oxygen therapy, HBOT) 相關於血液動力學，特別與心率降低以及血壓增加可能有關；然而，在臨床實踐中，對於血液動力學變化的影響並不一致。本研究旨在評估高壓氧治療對於受測者其心率和血壓的影響，進一步地分析高血壓和糖尿病病患接受HBOT對其心率和血壓變化的效應。 方法：研究設計採回溯性病歷研究，收集在2021年6月至2022年6月期間接收HBOT的193名受測者之基本資料及臨床數據。在治療過程中，全部研究對象被分別置於相同的單人高壓氧艙，艙內壓力大於1.4個絕對大氣壓力，並且呼吸100%氧氣，治療時間為60分鐘，受試者在每次接受HBOT前後1-5分鐘內被測量心率和血壓。對於HBOT前後之心率和血壓之變化，使用配對t檢定進行比較；使用混合模式 (mixed model) 分析重複測量的資料，探討HBOT前後對於心率和血壓變化之效應。 結果：在接受HBOT之後，研究對象的心率顯著地下降6.9次/分鐘 (95% CI = -7.3--6.4)，平均動脈壓顯著地上升3.3 mmHg (95% CI = 2.8-3.9)，收縮壓顯著地提高3.6 mmHg (95% CI = 2.8-4.4)，舒張壓亦顯著地增加3.2 mmHg (95% CI = 2.6-3.7)，更明顯的結果在高血壓和糖尿病患者中呈現。透過多變項混合模式調整潛在干擾因子的影響後，模式分別顯示HBOT之後相較於HBOT之前的心率具有顯著的下降 ( = -6.9, p < 0.01)，對於平均動脈壓 ( = 3.4, p < 0.01)、收縮壓 ( = 3.7, p < 0.01) 或舒張壓 ( = 3.2, p < 0.01) 都具有顯著的增加；然而，HBOT次數對於心率和血壓並未具有統計顯著性。 結論：HBOT可以導致心率顯著下降、血壓明顯升高，尤其是接受HBOT的高血壓和糖尿病患者。
並列摘要
Introduction: Hyperbaric oxygen therapy (HBOT) is associated with hemodynamics, particularly possibly a reduction in heart rate and an increase in blood pressure; however, the effect on hemodynamic changes is inconsistent in clinical practice. This study aims to evaluate the effect of HBOT on the subjects’ heart rate and blood pressure and further analyze the effect of HBOT on the changes in heart rate and blood pressure in patients with hypertension and diabetes. Methods: The research design adopts a retrospective medical record study to collect the essential information and clinical data of 193 subjects who received HBOT from June 2021 to June 2022. During the treatment, all subjects were placed in the same single-person hyperbaric oxygen chamber, the pressure in the chamber was greater than 1.4 atmospheric absolute pressure, and they breathed 100% oxygen, and the treatment time was 60 minutes. Subjects were measured within 1-5 minutes before and after each HBOT session for heart rate and blood pressure. For the changes in heart rate and blood pressure before and after HBOT, the paired t-test was used to compare; the mixed model was used to analyze the repeated measurement data to explore the effect of HBOT on the changes in heart rate and blood pressure. Results: After receiving HBOT, the heart rate of the research subjects decreased significantly by 6.9 beats/min (95% CI = -7.3--6.4), the mean arterial pressure increased significantly by 3.3 mmHg (95% CI = 2.8-3.9), the systolic blood pressure increased significantly by 3.6 mmHg (95% CI = 2.8-4.4), and diastolic blood pressure also increased significantly by 3.2 mmHg (95% CI = 2.6-3.7), with more pronounced results seen in hypertensive and diabetic patients. After adjusting for the influence of potential confounding factors through the multivariate mixed model, the models showed a significant decrease in heart rate after HBOT compared with before HBOT ( = -6.9, p < 0.01) and significant increase for all of mean arterial pressure ( = 3.4, p < 0.01), systolic blood pressure ( = 3.7, p < 0.01) or diastolic blood pressure ( = 3.2, p < 0.01); however, HBOT times were not statistically significant for heart rate and blood pressure. Conclusions: HBOT can cause a significant in heart rate and a prominent increase in blood pressure, especially in hypertensive and diabetic patients receiving HBOT.