Okano Ayaka, Masuhara Shun, Ota Sonoka, Motegi Chie, Takabayashi Noriko, Ogino Tetsuya
Department of Nursing Science, Faculty of Health and Welfare Science, Okayama Prefectural University, Soja, Okayama 719-1197, Japan.
Acta Med Okayama. 2017 Dec;71(6):485-491. doi: 10.18926/AMO/55585.
We examined postprandial body positions' effects on gastrointestinal motility, the autonomic nervous system and subjective comfort, i.e., whether lowering the head after a meal is beneficial for gastrointestinal motility and the prevention of pressure ulcer. We examined 10 healthy subjects and compared 3 body positions: (1) Seated upright. (2) Lying on a bed with the head at 60° and knees up by 20° (60° position). (3) Identical to (2) until post-meal; the head was then lowered to 30° (60°-30° position). Gastrointestinal motility was assessed as gastrointestinal sounds measured by sound-editing software. Digital plethysmography assessed autonomic nerve function as heart rate variability. The pressure ulcer risk was estimated as subjective comfort/discomfort using a visual analog scale. Gastrointestinal sounds increased post-meal. The 60°-30° position showed the highest number of sounds and longest cumulative sound duration. Post-meal, sympathetic activation was suggested in the 60° position, whereas vagal activity was relatively preserved in the 60°-30° position. The 60°-30° position was the most comfortable, and the 60° position was least comfortable. Lowering the head after a meal is beneficial to augment gastrointestinal motility and decrease the pressure ulcer risk. The 60° head-up position increases the pressure ulcer risk.
我们研究了餐后体位对胃肠动力、自主神经系统和主观舒适度的影响,即饭后低头是否有利于胃肠动力及预防压疮。我们对10名健康受试者进行了研究,并比较了3种体位:(1) 直坐。(2) 头部抬高60°、膝盖抬高20°躺在床上(60°体位)。(3) 饭后保持与(2)相同的体位;然后将头部降至30°(60°-30°体位)。通过声音编辑软件测量胃肠声音来评估胃肠动力。采用数字体积描记法通过心率变异性评估自主神经功能。使用视觉模拟量表将压疮风险评估为主观舒适度/不舒适度。饭后胃肠声音增加。60°-30°体位的声音数量最多,累计声音持续时间最长。饭后,60°体位提示交感神经激活,而60°-30°体位相对保留迷走神经活动。60°-30°体位最舒适,60°体位最不舒适。饭后低头有利于增强胃肠动力并降低压疮风险。头部抬高60°体位会增加压疮风险。