経皮酸素分圧値を指標とした除圧ケアおよびマッサージ効果の検討

Study of the Prevention of Pressure Ulcer Development：Evaluation of the Pressure Reduction with Support Surfaces and the Management with Massage by Measurement of TcPO2

要旨

　褥創予防のケアといわれる除圧用具とマッサージの効果について，健常人を対象に仙骨部の経皮酸素分圧（TcPO₂）を測定することにより以下の結果を得た．各除圧用具とコントロールの布団・パッドの圧迫前値に対する60分圧迫中のTcPO₂の変化率の割合を比較したところ，各除圧用具間で有意な差があった．円座，エアーマットレス，クレーターマットレス，布団，マットレスパッドの順でTcPO₂値が高く，除圧効果があると言えた．5分間マッサージを付加した後に60分間仰臥位で圧迫し，圧迫を除去した後のTcPO₂の変化をマッサージしない群と比較した．その結果，5分間マッサージ有群と無群ではTcPO₂の回復時間には有意差はみられなかった．

　以上より，褥創予防には除圧用具としてエアーマットレスが有効であること，圧迫する前に予めマッサージすることはTcPO2を指標として見た限り，その意義は見い出せなかった．

Abstract

　To evaluate the effectiveness of support surfaces and massage as management for prevention of pressure ulcers, we measured the transcutaneous oxygen tension (TcPO₂) at sacral resion in healthy subjects. The ratio of TcPO₂ values taken during pressure application for 60 minutes to TcPO₂ values before pressure application was compared between treatment of three support surfaces (ring cushion (donut-type), air-mattress, urethane foam-mattress) and treatment of futon, mattresses pad as control. The significant difference of TcPO₂ ratio had been demonstrated among each support surfaces. The decreases of TcPO₂ ratio were less in the subjects treated with, in order of significance, ring cushion, air-mattress, urethane foam-mattress, futon, mattress pad. The recovery time of TcPO₂ after relief of pressure that returns to the same level prior to application of pressure was analyzed in the subjects with or without treatment of massage prior to for 5 minutes pressure application. There was no significant differences between recovery time of subject treated with massage and that without treatment. These results suggest that air-mattress is most effective for prevention of pressure ulcer development as support surface and it will be necessary to re-evaluate the significance of massage treatment in prevention of pressure ulcers.