高压氧治疗时患者舱内心率变化特征及趋势分析

Characteristics of heart rate changes and its trend in patients during hyperbaric oxygen therapy

目的探讨高气压下吸氧患者在氧舱内的心率变化特征。方法采用氧舱内动态心电记录仪全程记录31例患者共227人次高压氧治疗时心率变化数据,记录分析最快且>100次/min和最慢且<60次/min心率出现的时间段,对比分析在空气加压氧舱内升压阶段、2个稳压治疗阶段和减压阶段最快和最慢心率出现的频次。结果最快且>100次/min出现156次,最慢且<60次/min心率出现76次;最快心率和最慢心率均以减压期出现频次最多,其次是升压期,稳压治疗期最少,各期出现频次的比较差异有统计学意义(P<0.01)。长期接受高压氧治疗的个案分析显示心率总体呈减慢趋势。结论高压氧治疗时舱内气压的变化可导致患者一过性心率明显变化,提示在给患者行高压氧治疗前应评估患者的心功能,在治疗时应有相应的处置预案。

Objective To explore the characteristics of heart rate changes in patients with hyperbaric oxygen inhalation in oxygen chamber.Methods A total of 31 patients were selected,and the changes of their heart rate during hyperbaric oxygen treatment were recorded for 227 person/times by the dynamic electrocardiograph in the oxygen chamber.The period of the fastest heart rate above 100 beats/min or the slowest one below 60 beats/min would be counted as a change.The frequencies of both the fastest and the slowest heart rates periods occurrences in the compression stage,the two stable pressure treatment stages,and the decompression stage in the oxygen chamber were compared and analyzed.Results There were 156 times of the fastest heart rate above 100 beats/min,and 76 times of the slowest one below 60 beats/min.The highest frequencies of the fastest and slowest heart rate periods occurrences were both in the decompression period,followed by those in the compression period,and then those in the stable pressure period.The differences among the frequencies of period occurrence were statistically significant(P<0.01).The case study of long-term hyperbaric oxygen therapy showed that the heart rate had the trend of slowing down in general.Conclusion During hyperbaric oxygen treatment,the air pressure change in the chamber can lead to a transient and obvious change of the patients’heart rate,which suggests that the patients’heart functions should be evaluated before hyperbaric oxygen treatment,and the corresponding emergency response plans during hyperbaric oxygen treatment should be prepared in advance.