瘫痪患者电动站立床训练致直立性低血压的相关分析

Related analysis of orthostatic hypotension by electric standing bed exercise in paralytic patients

目的:分析电动站立床训练时,可能影响患者发生直立性低血压或出现头晕、胸闷、心悸等不适的相关因素。方法:对2003-03/12在佛山市第一人民医院康复科进行电动床站立训练的58例瘫痪患者,记录其年龄、性别、职业、诊断、症状、伴发病、病程、卧床时间、每次站立训练持续时间、站立角度等,分别使用χ2检验和多元逐步回归方程进行单因素及多因素相关性分析。结果:单因素资料分析显示,下列因素为患者站立训练时出现体位性低血压或不适的危险因素:职业—病前从事非体力劳动者(P<0.01)、卧床时间>1个月(P<0.01)、第1周站立训练角度>70°(P<0.01)、并发心脏病、糖尿病等,这些患者在训练过程中容易诱发体位性低血压或出现头晕、胸闷等不适。而性别(P>0.05)、年龄(P>0.05)、瘫痪情况等与引起体位性低血压或头晕、胸闷等不适关系不大。多因素回归分析显示,患者第1周站立训练的角度、卧床时间、是否有伴发病及职业等密切相关。结论:在给患者进行斜床站立时,要注意影响患者发生体位性低血压的危险因素,训练过程中密切观察病情,以防发生不良反应,使训练能安全、有效进行。

AIM:To analyze related factors which maybe affect the attack of orthostatic hypotension or discomfort such as dizziness,chest distress and palpitation by electric standing bed exercise.METHODS:From March to December 2003,58 paralytic patients were treated by electric standing bed exercise in the Department of Rehabilitation Medicine,Foshan First People's Hospital.Such information as age,gender,occupation,diagnosis,symptom,complication,medical history,the time of lying in bed,the time of continual standing and the angle of standing was recorded.Single factor and multiple factor analyses were retrospectively performed to these data by χ 2 test and multiple step by step logistic regression equation.RESULTS:As shown in the single factor analysis,risk factors in patients treated by standing bed exercise related to orthostatic hypotension included occupation,the time of lying in bed,the standing angle on the first week,and such complication as diabetes,cardiac disease.Those who were non manual workers(P< 0.01),lied in bed for more than one month(P< 0.01),stood at more than 70° on the first week(P< 0.01),had above mentioned complication were at high risk for orthostatic hypotension or discomfort such as dizziness and chest distress.However,gender(P >0.05),age(P >0.05),degree of paralysis were not related to orthostatic hypotension and discomfort.Multiple regression analysis revealed that the standing angle on the first week,the time of lying in bed,complication,occupation were closely related to orthostatic hypotension.CONCLUSION:For the patients treated with standing bed exercise,it is cautioned to know the risk factors related to orthostatic hypotension and observe patients' general condition during standing bed exercise in order to prevent adverse reaction and assistant patients with exercise safely and effectively.