腦部損傷併發低血壓病人對不同臥位時之腦部灌流及生理指標的影響

目的：探討腦部損傷併發低血壓病人對不同臥位時之腦部灌流與生理指標的影響。方法：採類實驗性研究設計，以方便取樣，招募台灣北部某醫學中心之神經科加護病房84位腦部損傷併發低血壓病人為研究對象。依照研究設計監測研究對象在平躺與頭低腳高姿勢1分鐘、3分鐘、5分鐘、10分鐘、15分鐘、30分鐘、60分鐘、120分鐘等8個觀察點的顱內壓、腦灌流及生理指標，所測的測量值進行推論性統計分析。結果：（1）腦部灌流方面，在平躺及頭低腳高二組間不具統計意義；而顱內壓於二組間會隨著時間增加。（2）生理指標方面，在平躺及頭低腳高二組間不具統計意義，結論：研究結果可作為照護腦部損傷病人，當合併低血壓時，改變臥位時的參考，在考量病情下，提供適當適切的臥位，使病人的生理指標、顱內壓與腦部灌流壓更趨於穩定狀態，減少合併症的發生。

關鍵字

腦部損傷；低血壓；頭低腳高姿勢；腦部灌流壓；顱內壓

並列摘要

Purposes: The aim of the study was too explore the effects of different berths on cerebral perfusion pressure and physiological parameters in patients with intracranial disorder patients complicated with hypotension Method: The quasi-experiment recruited 84 patients with brain injury complicated with hypotension from the neurological intensive care unit in a medical center in northern Taiwan. Intracranial pressure, brain perfusion, and physiological indicators of each subject in the positions of lying flat and trendelenburg in 1 minute, 3 minutes, 5 minutes, 10 minutes, 15 minutes, 30 minutes, 60 minutes and 120 minutes were monitored. Results: There was no statistically significant difference in brain perfusion between the group of lying flat and trendelenburg, but intracranial pressure increased over time. There was no statistically significant difference in physiological indicators between the group of lying flat and trendelenburg. Conclusion: The results of this study can be used as a reference for changing lying positions when taking care of patients with intracranial disorder complicated with hypotension. Individualized lying positions can be provided to stabilize patients' physiological indicators, intracranial pressure, and cerebral perfusion pressure to reduce the risk of complications.