脑梗死患者急性期血压变化规律及护理  

The changes of blood pressure in patients with acute cerebral infarction and nursing

作　　者：杨晓燕 姚键 刘国超 

机构地区：[1]广东省惠东县人民医院,516300

出　　处：《中国实用医药》2013年第16期206-208,共3页China Practical Medicine

基　　金：惠州市科技项目(项目编号:2011Y204)

摘　　要：目的探讨脑梗死患者急性期的血压变化规律和护理方法。方法收集未经血压干预的急性期脑梗死患者157例,按其致病因素进行TOAST分型,同时按其病变部位和病灶大小进行OCSP分型;分别观察各分型1周内的血压变化规律,并探讨合理的护理方法。结果首测血压:急性脑梗死入院后,首次测量血压增高者有141例(89.8%),其中108例(69%)有高血压史,101例(64.3%)有药物治疗史;且有药物治疗史患者的平均收缩压显著高于其他患者(P<0.05)。总体规律:脑梗死急性期患者入院当天首测血压值为其最高值,之后7d呈逐渐下降趋势,以前24h最为明显,1周内可基本降至正常水平。分型差异:不同的TOAST及OCSP分型患者血压的分布区间不同,以收缩压表现最为明显;其中大动脉粥样硬化型及腔隙性梗死患者收缩压始终处于较高水平,且其均值显著高于其他TOAST分型(P<0.05);后循环型梗死患者收缩压始终处于较低水平,且其均值显著低于其他OCSP分型(P<0.05)。结论脑梗死患者急性期血压呈显著上升趋势,多数患者经密切护理可在发病1周内降至正常水平;其急性期血压值因患者药物史、发病原因、发病部位及病灶范围等差异有所变动;在护理过程中应加强巡视,进行个体化处理。Objective To investigate the changes of blood pressure in patients with acute cerebral infarction and nursing methods of law.Methods 157 patients with acute cerebral infarction were collected without the intervention of blood pressure, TOAST type according to the pathogenic factor, and OCSP type according to its location and size of the lesion were observed; each type of changes of blood pressure in 1 weeks, and to explore the nursing methods of reasonable.Results The measured blood pressure： admission after acute cerebral infarction, the first measurement of blood pressure levels were 141 cases （89.8%）, of which 108 cases （69%） had the history of hypertension, 101 cases （64.3%） with drug treatment history; and the average systolic blood pressure in patients with history of drug treatment was significantly higher than that of the other patients （P 0.05）.General rule： admission in patients with acute cerebral infarction on the first measure blood pressure value is the highest value, then 7 d decreased, 24 h was the most obvious, 1 weeks can be decreased to normal level.Type differences： the distribution range of TOAST and OCSP in different types of blood pressure in patients with different, with systolic blood pressure was the most obvious; the large artery atherosclerosis and lacunar infarction in patients with systolic pressure is always at a high level, and the mean value was significantly higher than that of other TOAST types （P0.05）; posterior circulation infarction patients with systolic pressure type is always the low level, and the mean value was significantly lower than that of other OCSP type （P0.05）.Conclusion Blood pressure in patients with acute cerebral infarction was significantly increased, the majority of patients after close nursing can be reduced to normal level at 1 weeks in the acute phase of disease; blood pressure values for drug history, etiology, pathogenesis in patients with location and range of lesions were changed; in the nursing process should strengthen

关 键 词：脑梗死急性期 血压变化规律 护理方法 OCSP分型 TOAST分型 

分 类 号：R473.74[医药卫生—护理学]