Department of Nursing, Kobe City Medical Center, General Hospital, Kobe City, Japan.
Biol Res Nurs. 2013 Jul;15(3):285-91. doi: 10.1177/1099800412437929. Epub 2012 Apr 23.
The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle-brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO₂): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO₂ ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO₂ < 10 mmHg (Group C). Heel blood flow was monitored using tcPO₂ sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO₂ for the first 10 min, and change in tcPO₂ after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO₂ for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO₂ after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO₂ < 10 mmHg might be necessary after loading.
本研究旨在评估 65 岁以上卧床成年人在负重和减压过程中足跟血流的差异。根据踝肱指数（ABI）和经皮氧分压（tcPO₂），患者被分为三组：（1）ABI≥0.8 的患者（A 组）；（2）ABI＜0.8 但足跟 tcPO₂≥10mmHg 的患者（B 组）；（3）ABI＜0.8 且足跟 tcPO₂＜10mmHg 的患者（C 组）。使用 tcPO₂传感器监测足跟血流。足跟数据采集：（1）足跟悬于床面上方（预加载）；（2）置于床面 30 分钟（加载）；（3）再次悬于床面上方 60 分钟（减压）。使用三个参数评估减压期间足跟血流：氧恢复指数（ORI）、前 10 分钟总 tcPO₂和减压 60 分钟后 tcPO₂的变化。C 组（n=8）的 ORI 明显短于 A 组（n=22）和 B 组（n=15）。C 组减压前 10 分钟的总 tcPO₂明显少于 A 组和 B 组。减压 60 分钟后 C 组的 tcPO₂变化小于 A 组。基于这些发现，ABI＜0.8 且足跟 tcPO₂＜10mmHg 的老年患者在负重后可能需要额外的预防足跟血流减少的护理措施。
