护理人员急进高原血氧饱和度、脉率变化的影响研究

The study about the change of the blood oxygen saturation and pulse rate of the nursing staff under abrupt highland advancing

目的了解护理人员急进高原血氧饱和度、脉率参数的变化特征,为护理人员急进高原参加援藏工作自我保护提供依据。方法选取2017年11-12月急进海拔3650m拉萨地区参加援藏工作的护士12名为急进组,选取武警西藏总队医院护士12名为高原组。观察1个月中24名护士共360个班次在开始工作前和工作后0.5、1.0、3.0、6.0h工作期间的血氧饱和度、脉率参数变化趋势,及急进组护士不同年龄段、不同性别、不同班次在180个班次开始工作前和工作后0.5、1.0、3.0、6.0h工作期间的血氧饱和度、脉率参数变化趋势。结果2组护士开始工作前的血氧饱和度比较差异无统计学意义(P>0.05)。急进组护士工作后0.5、1.0、3.0、6.0h血氧饱和度分别为0.91±0.01、0.91±0.02、0.91±0.02、0.91±0.01,高原组护士分别为0.94±0.02、0.93±0.01、0.94±0.01、0.94±0.01,2组比较差异有统计学意义(t=5.153~8.151,P<0.05或0.01);急进组护士开始工作前和工作后0.5、1.0、3.0、6.0h脉率分别为(85.38±2.38)、(91.62±2.79)、(89.79±2.05)、(89.12±2.29)、(89.72±2.31)次/min,高原组护士分别为(91.52±2.64)、(93.52±2.82)、(93.52±2.73)、(94.52±2.56)、(93.52±2.96)次/min,2组比较差异有统计学意义(t=3.875~10.182,P<0.01)。急进组护士白班、中班、夜班开始工作后0.5、1.0、3.0、6.0h血氧饱和度比较差异有统计学意义(t=3.561~8.321,P<0.05或0.01),脉率比较差异有统计学意义(t=1.529~4.968,P<0.05或0.01)。急进组护士21~30岁、31~40岁2个年龄段在开始工作前和工作后0.5、1.0、3.0、6.0h血氧饱和度和脉率比较差异均无统计学意义(P>0.05)。急进组护士不同性别开始工作后0.5、1.0、3.0、6.0h血氧饱和度比较差异有统计学意义(t=4.273~8.329,P<0.01);开始工作前和工作后0.5、1.0、3.0、6.0h脉率比较差异有统计学意义(t=3.283~6.719,P<0.05或0.01)。结论护理人员急进高原工作,在工作期间血氧饱和度均有明显降低,脉率有所增快,并且夜间工作期间血氧饱和度降低、脉率增加比较显著,随着工作时间的延长逐渐适应。性别、工作时间段影响着护理人员血氧饱和度、脉率变化趋势。

Objective To evaluate the changes in blood oxygen saturation and pulse rate of the nurses under abrupt highland advancing and provide the fundamentals for those nurses under abrupt highland advancing to Tibet.Methods We selected 12 nursing staffs abruptly advanced to Lhasa at an altitude of 3 650 meters for Abrupt Advancing Group then chose 12 nursing staffs over there for Highland Group from November 2017 to December 2017.To assess whether there is a difference about the change of blood oxygen saturation and pulse rate between these two groups,we measured them in 24 nurses and 360 shifts before work and at 0.5,1.0,3.0,6.0 h after work.Then,we compared the changes in blood oxygen saturation and pulse rate between different ages,sexes,shifts.Results No significant difference in blood oxygen saturation was observed between the two groups before starting work (P > 0.05).Blood oxygen saturation of Abrupt Advancing Group (0.5,1.0,3.0,6.0 h) after work was respectively 0.91±0.01,0.91±0.02,0.91±0.02,0.91±0.01.Meanwhile,the parameters of Highland Group was separately 0.94±0.02,0.93±0.01,0.94±0.01,0.94±0.01.There was a significant difference between the two groups (t=5.153-8.151,P < 0.05 or 0.01).Before work,the pulse rate was (85.38±2.38),(91.62±2.79),(89.79±2.05),(89.12±2.29),(89.72±2.31) times/min for Abruptly Advancing Group,(93.52±2.64),(93.52±2.82),(94.52±2.73),(94.52±2.56),(93.52±2.96) times/min for Highland Group.The difference between the two groups was statistically significant (t=3.875-10.182,P < 0.01).Besides,no difference about the changes in blood oxygen saturation of Abruptly Advancing Group between different shifts was observed (t=3.561-8.321,P < 0.05 or 0.01).The difference of pulse rate in Abruptly Advancing Group was statistically significant (t=1.529-4.968,P < 0.05 or 0.01).There was no significant difference of blood oxygen saturation and pulse rate in Abruptly Advancing Group between the age of 21 to 30 and 31 to 40 years old,whether before or after work (P > 0.05).A positive difference between the sexes could be found about the changes in the blood oxygen saturation of Abruptly Advancing Group at 0.5,1.0,3.0 and 6.0 h after work.What's more,there was a significant difference in pulse rates before and after work (t=3.283-6.719,P < 0.05 or 0.01).Conclusions The nursing staff in the Abruptly Advancing Group shows decreased blood oxygen saturation and increased pulse rate compared to those in the Highland Group during working period.In addition,the changes show more significant in those working at night,but they adapted gradually.Gender and working time have a significant effect on the change in blood oxygen saturation and increased pulse rate of the nursing staff.