房颤患者两种血压测量方法的比较  

Comparative of two blood pressure measurements in patients with atrial fibrillation

作　　者：贾文冬[1] 华慧娟[1] 姚宏[1] 杨皓珺[1] 许芳蕾[2] 

机构地区：[1]同济大学附属同济医院五官科,上海200065 [2]同济大学附属同济医院护理部,上海200065

出　　处：《中华现代护理杂志》2010年第7期777-778,共2页Chinese Journal of Modern Nursing

摘　　要：目的探讨使用心脏监护仪和汞柱台式血压计测量房颤患者血压的一致性，为临床上选择正确的血压测量方法提供依据。方法随机选取住院治疗的房颤患者180例和正常心律患者160例，使用两种方法测量其血压，比较两种方法所测血压值有无差异。结果180例房颤患者使用监护仪测得的收缩压为（126±22）mmHg（1mmHg=0．133kPa），舒张压为（75±13）mmHg，使用汞柱台式血压计测得的收缩压为（134±25）mmHg，舒张压为（69±15）mmHg，两种方法所测得的血压值差异有统计学意义（收缩压比较：t=3．2230，P=0．0014；舒张压比较：t=4．0555，P=0．0001）。在160例正常心律患者使用这两种方法测得的收缩压分别为心脏监护仪测得（128±24）mmHg和汞柱方式血压计测得（129±25）mmHg，舒张压分别为心脏监护仪测得（78±11）mmHg和汞柱方式血压计测得（76±12）mmHg，两种方法测得的血压值差异无统计学意义（收缩压比较：t=0．3650，P=0．7154；舒张压比较：t=1．5541，P=0．1212）。结论房颤可能影响监护仪测量血压的准确性，为房颤患者测量血压时，宜使用汞柱式血压计。Objective To explore the consistency between cardiac monitor and mercury sphygmomanometer for noninvasive blood pressure （BP） measurements in patients with atrial fibrillation, which may provide evidence for appropriate device to be applied clinically to patients with arrhythmia. Methods A cohort of 180 hospitalized patients with atrial fibrillation and a total of 160 hospitalized patients with regular heart rhythm were randomly recruited. The BP of every subject was measured with both a mercury device and a cardiac monitor using the same arm. t test was used to compare the BP parameters obtained with the two devices and a two-tailed P 〈 0. 05 was considered to be statistically significant. Results In 180 patients with atrial fibrillation, the mean systolic BP and diastolic BP measured by the mercury sphygmomanometer were （ 126 ± 22）mm Hg and （75± 13）mm Hg respectively, whereas the cardiac monitor measured systolic BP as （ 134±25） mm Hg and diastolic BP as （69 ± 15 ）mm Hg. There was statistically significant difference with regard to BP values between the two devices （ for systolic BP, t = 3.223 O,P = 0. 001 4 ; for diastolic BP, t = 4. 055 5, P = 0. 0001 ）. However, in 160 patients with regular cardiac rhythm, no significant difference was found for the BP data obtained with the two devices [ for systolic BP, （ 128± 24） vs （ 129 ± 25 ）, t = 0. 3650, P = 0. 715 4 ; for diastolic BP, （78± 11 ） vs （76 ±12）, t = 1. 554 1, P =0. 121 2 ]. Conclusions Atrial fibrillation may exert adverse effect on the accuracy of BP measurements taken using cardiac monitor and in patients with atrial fibrillation. Mercury sphygmomanometer is preferable for BP measurement.

关 键 词：房颤 血压 血压计 

分 类 号：R541.75[医药卫生—心血管疾病]