体位と腹腔内圧について

－腹腔内圧形成と上半身拳上－

抄録

The purpose of study is to obtain the relation of the bed-lying positions with intraabdominal pressure which is concerned to the respiratory and circulate function. The knowledge is important to select the bed-lying position for the effective nursing care to patient with the probrem of respration and / or circulation.
The method : For the chair-sitting posistion, standing position, and bed-lying positions holding by 15°, 30°, 45°, 60°, 75°, 90°, up the upper half-body to the horizon by the gadget bed, the intra-abdominal pressure, the amplified respiration curves on chest wall and abdominal wall, the electromyogram with electrod on the surface of M. obliquus ext. abd. and M. rectus abd., and the rate of pulseusing E.C.G., were examined under the states of the quiet respiration, the forced respiration and the strains during inspiration and exspiration.
The equipment to measure the intraabdominal pressure was consisted of the pressuresensitive radio transducer and the gastric-tube type receiver which was deviced by us. After the top of receiver was settled certainly on 45cm distance from the incisor, we measured the intragastric pressure which was approximately as the intra-abdominal pressure (P.R. DAVIS.).
The volunteer subjectswere 10 healthy nurses with the age of 19～39 years.
The results were as follows:
1)　The highest intraabdominal pressure was observed by the inspiraton with strain, and the less higher pressure was seen by the exspiraton with strain, the forced respiration and the quiet respiration.
2)　Under each type of respiration and strain form, the intraabdominal pressure increased according to the degree of holding up the upper half-body, and the highest was obtained 28.3mmHg by the inspiration with strain by 90°holding up position.
3)　The difference of pressure between of the inspiratory and the exspiratoly strain by the every bed-lying position went down almost on the same way. The difference of pressures between the quiet respiration and those with strain, was tended to increase acording rais-ing the upper half-body.
4)　The type of respiration was ofserved as the chest type when the upper half-body was laid horizontally, but it came gradually into the abdominal type during the rpper half-body was raised.
5)　On the electromyogram, the action potential of the abdominal wall muscles tended to decrease acording to lift up the upper half-body by each form of the respiration and the strain.
Holding the upper half-body with some angle to the horizon seems to be significantly effective for the nursing plan to control the intra-abdominal pressure such as by chance of cough, expectoration, defecation and labor.