奥氮平对老年患者卧-立体位转换时血压的影响与护理对策  

The Side-effects of Olanzapine on Orthostatic Blood Pressure Regulation in Elder Inpatients and The Nursing Measures of Orthostatic Hypotension

作　　者：徐晶宇[1] 何娟娟[1] 胡娟[1] 徐亚金[1] 徐乐平[1] 

机构地区：[1]解放军第102医院,江苏省常州市213002

出　　处：《实用心脑肺血管病杂志》2010年第9期1322-1324,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨奥氮平对老年患者卧-立体位转换时血压调节机制的影响。方法 67例接受奥氮平治疗(5～10mg/d)的住院老年患者,于治疗前后分别测定卧、立位血压,计算卧-立位血压差值,并观察治疗前、后直立性低血压发生率。结果老年患者在接受奥氮平治疗后,卧-立位收缩压的差值、舒张压的差值及直立性低血压的发生率均高于治疗前,差异均有统计学意义(分别P=0.000、0.009、0.005);既往无抗精神病药使用史(P=0.007)、治疗前卧-立位收缩压差值较大者(P=0.023)更易发生直立性低血压。结论奥氮平可影响老年患者卧-立体位转换时的血压调节机制,导致直立性低血压发生。护理中应重点观察,预防优先,早期识别,及时处置。Objective To evaluate the adverse effects of olanzapine on orthostatic blood pressure regulation in elder inpatients.Methods 67 elder inpatients with mental disorder were involved and assigned to treatment with olanzapine（5-10mg/d）.The blood pressure was measured in lying-position and standing-position respectively pre-and pro-treatment.The delta of systolic blood pressure,diastolic blood pressure were calculated by subtraction of two position,and the prevalence of orthostatic hypotension was observed.Results The delta of systolic blood pressure,diastolic blood pressure during the lying-standing position exchangement were significantly higher after treatment than before treatment（P=0.000,0.009 respectively）,the same as the prevalence of orthostatic hypotension（P=0.005）.In multivariate analysis,the risk factors for orthostatic hypotension were drug navie（P=0.007）and higher delta of systolic blood pressure（P=0.023）during the position exchangement before treatment.Conclusion Olanzapine can effect the orthostatic blood pressure regulation in elder inpatients and lead to the orthostatic hypotension.We have to observe key population,prevent first,recognize early and handle in time.

关 键 词：奥氮平 直立性低血压 护理 血压调节 体位 

分 类 号：R473.5[医药卫生—护理学]