心拍数，酸素消費量からみたより心負荷の少ない排便方法の検討（II報）—排便前・後動作における介助の効果

Effects of assistance during activities in pre- and post-defecation on the heart rate and oxygen consumption

　重症患者でも排便だけはベッドから降りてしたいという希望を持っている者が多いが，医師や看護婦はともすればそれを許可せず，ベッド上で便器を使うことを勧める。排便中のトラブルの多くは努責による急激な循環動態の変化に起因している^1,2）と言われているが，それ以外に著者らは排便前後の体位変換や移動動作による負荷も無視できず，前後動作抜きに排便負荷は論じられないことを指摘した^3）。

　そこで今回，排便前・後動作における負荷を軽減するためにベッド上仰臥位および60゜坐位での便器使用とベッドから降りたポータブル便器使用の3方法について前後動作の介助を行い，心拍数と酸素消費量から自力と介助の比較検討をした。

Certain questions remain to be determined whether the taxing on the cardiovascular systems was imposed on not only during defecation but also the periods of the pre- and post defecation, especially in the patients with heart disease.

The changes of the heart rate and oxygen consump-tion with and without assistance in the pre- and post activities of defecation were observed using a bedpan in the supine position, bedpan in 600 head up semi-sitting position and bedside commde in the seven healthy female volunteers to assess the influence of assistance in the defecation on the cardiovascular systems.

The subjects were allowed to monitor their heart rate during pre- and post activities of defecation conti-nuously. In addition, the oxygen consumption and meta-bolic equivalents (METS) were determined and calcu-lated using gas analyzer.

The results were obtained as follows :

1) Experiments performed, using a bedpan in supine with assistance in the pre- and post defecation provided a significant lower increment of heart rate and METS than obtained without assistance.

2) The inhibition of the increment of heart rate with assistance in the pre- and post defecation could be demonstrated by means of a bedpan in 60° head up semi-sitting position, but no effect on the METS.

3) In all these experiments, the maximal increases of the heart rate and METS were found in the pre- and post defecation activities without assistance from bedside commode to the bed.

4) The results obtained from these experiments sug-gested that the assistance in the pre- and post defecation could be responsible for the less taxing on the cardio-vascular systems which is provided by the low incre-ment of heart rate, oxygen consumption and METS, in the bedpan in supine and the bedpan in 60° head up semi-sitting position.