血压计的使用及注意事项

测量血压是护理工作中最基础的工作之一。保证测量数据的准确是很重要的,人工测量和自动测量用的血压计所操作的方法是一样的。自动测量选用柯氏音法和振荡法(示波法)。人工测量的血压计是水银柱血压计和气压表式血压计。在具体操作中应采取相应措施保证测量的准确。     

无创血压测量技术与进展

介绍了无创血压测量技术的发展简史，重点分析了当今无创血压测量领域里具有代表性的柯氏音听诊法、示波法、恒定容积法的原理和特点，综述了国内外血压测量的现状．对血压无创测量技术的发展趋势提出了展望。     

基于振动法和柯氏音法的无创血压测量值差异性研究

对无创血压测量仪测量值误差异性展开分析。用与各种血压测量技术进行比较的方法，着重分析了振动法无创血压测量和柯氏音听诊法。使用振动法无创伤血压测量监护仪和柯氏音听诊法对样本人群进行了血压测量，分析所得数据，结果表明，基于振动法和柯氏音法无创血压测量仪测量值差异小，准确性也比较好。同时，也展望了无创血压装置未来的发展方向。     

混合式血压计研制及其数据处理方法

目的：研制一种能够替代汞柱式血压计的医用诊断级无汞血压测量装置。方法：使用电子压力测控技术替代水银柱式的压力显示模式,设计出一种将柯氏音听诊法与电子压力测控技术相结合的＂混合式＂血压计,并运用数据处理算法提高人工柯氏音听诊法的整体测量准确性。结果：在0~300 mmHg（1 mmHg=133.322 Pa）测量范围内,平均示值误差〈3.00 mmHg,最大实验标准偏差〈2.00 mmHg。结论：测量装置达到欧盟EN1060-3医用诊断级血压计测量标准,可对整个血压测量过程中容易引入操作者主观误差的环节进行误差控制,提高了测量系统的测量精度与可靠性。     

三种不同测量原理血压计测量结果差异性研究

目的探讨柯氏音测压原理血压计、示波法血压计、脉搏波法血压计测量血压结果的差异性。方法随机选择2015年10月至11月,在我院住院的患者及医务工作人员共计106例,其中男50例,女56例。年龄20岁~87岁,平均54岁。高血压患者51例,平均65岁;非高血压患者55例,平均42岁。分别使用柯氏音测压原理血压计、示波法血压计、脉搏波法血压计按相同操作规程测量肱动脉血压,比较三者测量结果的差异。结果柯氏音测压原理血压计、示波法血压计、脉搏波法血压计三种血压计测得的血压值差异均无统计学意义(P0.05)。以柯氏音测压原理血压计测得的血压值为标准,对脉搏波法血压计与示波法血压计测量血压值的准确性进行频数与构成比的分析,在一定程度上得出脉搏波法血压计所测得血压值与柯氏音测压原理血压计相对接近,浮动的幅度较小,更为准确。结论在血压测量方面,脉搏波法血压计测得血压值较示波法血压计测得血压值与柯氏音测压原理血压计更接近,且脉搏波法血压计更安全环保、操作简单、便于携带,可以应用于临床。     

示波法数字式电子血压计动态检定方法的探讨

目前越来越多数字式电子血压计进入医疗卫生用品市场,在医疗系统中有大量用于临床的无创血压监护仪和多参数监护仪等设备,其共同的特点是动态无创测量人体血压(收缩压和舒张压)。血压测量准确与否关系到广大人民群众生命健康安全。国家把血压计列为国家强制检定计量器具。目前大部分无创式的电子血压计采用示波法测量血压。计量部门对这些血压测量器具只能检定其静态指标,对于其测量血压(收缩压舒张压)准确度的检定,没有确实可行的方法和手段。因此很有必要对示波法电子血压计测量血压准确度的检定方法进行探讨。     

示波法数字式电子血压计动态检定方法的探讨

<正> 目前越来越多数字式电子血压计进入医疗卫生用品市场,在医疗系统中有大量用于临床的无创血压监护仪和多参数监护仪等设备,其共同的特点是动态无创测量人体血压(收缩压和舒张压)。血压测量准确与否关系到广大人民群众生命健康安全。国家把血压计列为国家强制检定计量器具。目前大部分无创式的电子血压计采用示波法测量血压。计量部门对这些血压测量器具只能检定其静态指标,对于其测量血压(收缩压舒张压)准确度的检定,没有确实可行的方法和手段。因此很有必要对示波法电子血压计测量血压准确度的检定方法进行探讨。     

血压测量技术的发展及动态血压监测技术的展望

目的回顾柯氏音听诊法、示波法两种传统无创血压测量技术的发展历史和基本原理,并分析其优势与劣势。简要介绍血压测量方法容积补偿法和张力测定法的原理及发展状况。分析基于脉搏波传导的血压测量的相关方法及原理,并对连续无创血压测量与"互联网"技术的结合以及血压大数据的利用价值,血压测量设备的发展趋势做出展望。     

关于水银式与电子式血压计临床测量血压值偏差的分析

在临床医疗护理中要大量地绘患者无创测量血压，无创血压测量的方法很多．诸如柯氏音法、测振法，超声法、双袖带法。恒定袖带法、逐拍跟踪法、张力测定法、恒定容积法等，临床实践中多采用柯氏音法、测振法。柯氏音法多应用于水银式或指针式普通血压计，测振法多应用于血压的电子自动测量，医护人员经常反映用普通的水银式或指针式血压计测量的血压与电子自动测量的血压值偏差很大。其实这里存在着一些误区。下面就这一问题笔者进行肤浅的探讨。     

一种新型血压测量装置设计及其辨识方法的研究

根据水银血压计测量的柯氏音原理,设计了一种新的基于听诊法电子血压测量系统:利用嵌入在电子血压计装置内部的微小拾音器,通过连通器直接拾取来自袖带耦合到的柯氏音信号;血压参数辨识算法则根据柯氏音与脉搏波时相的一致性,采用柯氏音能量幅度积计算每个脉搏对应柯氏音的特征值,并利用柯氏音特征值类聚法进行归类以确定其时相位置并最终得到血压值.经比对实验和统计分析表明,该血压测量装置与标准水银血压测量方法具有良好的一致性和准确性.     

无创动脉血压测量的研究现状

动脉血压测量的准确程度直接关系到疾病的早期发现、准确诊断、及时治疗和转归。对国内现有关于测量血压的工具、部位、体位、衣着、听诊器胸件位置和水银血压计位置等方面的研究进行综述,为医务人员寻求一种既经济方便、又快速准确的方法提供参考。     

Comparison of three devices for measuring blood pressure

Blood pressure measurement with two automatic devices, Dinamap 845 and Sentry, was compared with the standard mercury sphygmomanometer, by means of a 3-period crossover experiment. Both automatic devices read diastolic pressure considerably lower than the mercury sphygmomanometer (about 7 mmHg on average); agreement was better for systolic pressure. Device differences in individual patients were often much higher. To assess the patient's emotional pressor response during manual measurement, Dinamap was used to monitor blood pressure before, during and after measurement with the mercury sphygmomanometer. No rise in pressure was found. It is concluded that the three devices can often give different values, and that the physician's involvement cannot explain these differences.     

无创血压测量技术的改进与进展

介绍数种常规的无创血压测量方法-柯氏音法、示波法和双袖带法及其改进。重点对国际上连续无创血压测量的新型实用技术、方法及前景进行较为详细的介绍,如动脉张力测量法、动脉容积钳制法、脉搏波速度测量法、超声测压法以及小波分析和模糊识别技术在血压信号处理中的应用等。指出无创血压测量技术,尤其是无创连续血压测量方法有着巨大的市场需求;脉搏波速度测量法能实现真正意义上的连续无创血压测量,因此具有广泛的应用前景,而采用新理论进行连续的无创血压测量将是该领域的目标和发展方向。     

Measuring blood pressure at the wrist: more comfortable for patients and more convenient for doctors?

OBJECTIVES: To compare the agreement between conventional measurement of blood pressure and measurements obtained using two automated devices; and to compare how comfortable each of the three methods of measurement were for patients. METHODS: Blood pressure measurements and patient comfort scores were recorded using three different devices in 125-surgery and 40-community patients. The devices used were a conventional aneroid sphygmomanometer, an automated device that measured blood pressure on the upper arm and an automated device that measured blood pressure at the wrist. In each patient, the difference between the conventional and automatic measurement was calculated. The limits of agreement of each device were then calculated as the mean difference +/-1.96 standard deviations. RESULTS: In surgery patients, the width of limits of agreement of wrist measurement were 20.0 mm Hg and 12.1 mm Hg for systolic and diastolic blood pressure respectively, compared with 26. 4 mm Hg and 27.7 mm Hg for automatic arm measurement. In community patients, the width of limits of agreement of wrist measurement were 11.6 mm Hg and 11.0 mm Hg for systolic and diastolic blood pressure respectively, compared with 19.5 mm Hg and 12.1 mm Hg for automatic arm measurement. Surgery patients also reported that wrist measurement of blood pressure was significantly more comfortable than either manual or automatic arm measurement (mean comfort scores 4.03 for automatic wrist and 2.13 for automatic arm measurement, Friedman's Test, P<0.001). CONCLUSIONS: Blood pressure measurements taken using the wrist device agreed more closely with those obtained using a conventional aneroid sphygmomanometer than the arm device. The wrist device was also more comfortable for patients than two other methods of blood pressure measurement. Public Health (2000) 114, 165-168     

TL-200 Tensymetry连续无创血压与直接桡动脉测量不稳定血压的对比

目的：比较TL-200 Tensymetry连续无创血压与直接桡动脉测量不稳定血压的临床效果。方法：对本院收治的80例需进行连续实时动脉血压监测的患者,分别于两侧桡动脉采取无创连续血压监测系统（T-line）与直接桡动脉血压监测（A-line）进行血压监测,比较两种方法血压监测结果,并对结果进行分析。结果：T-line与A-line血压测定结果平均血压值基本一致,决定系数也较高;收缩压和舒张压均未出现回归关系的变化,表明T-line与A-Line血压测定结果具有高度一致性。结论：T-line能够实现实时、无创、连续、准确血压动态监测,较间断袖带式血压测量和直接桡动脉血压测量临床应用和推广价值更高。     

Replacing mercury-column sphygmomanometers

Mercury-based devices have a long history of use in the healthcare setting. However, mercury poses a significant occupational and environmental exposure hazard. In recognition of this hazard, the American Hospital Association and the U.S. Environmental Protection Agency have set a goal to eliminate mercury in healthcare by 2005. As a result, healthcare facilities are now under increasing pressure to replace mercury-based equipment. Thermometers and sphygmomanometer columns are the most prevalent sources of metallic mercury in the healthcare setting. Many hospitals have already swapped mercury thermometers for electronic devices. Replacing mercury sphygmomanometers, however, has been more problematic, as concerns have been raised about the accuracy of the alternatives. Despite these concerns, some hospitals have been able to eliminate or significantly reduce the presence of mercury sphygmomanometers. In this Guidance Article, we describe factors that healthcare facilities should consider when choosing from among the available blood pressure measurement methods, and we provide practical advice for facilities trying to make the switch from mercury sphygmomanometers to alternative methods.     

臂式电子血压计与汞柱式血压计测量结果对比观察

目的:为了探讨臂式电子血压计与汞柱式血压计血压测量结果的准确性,为临床血压测量提供指导。方法:从本院门诊患者中随机选取153例作为被测对象,分别对其采用臂式电子血压计和水银血压计进行血压测量,并分别将血压测量结果记为研究组和对照组,观察两组血压测量结果之间的差异。结果:研究组和对照组收缩压分别为(112.79±15.48)mmHg和(112.35±15.16)mmHg,组间差异不显著(P>0.05);研究组和对照组舒张压分别为(71.12±9.85)mmHg和(70.36±9.47)mmHg,组间差异不显著(P>0.05)。结论:臂式电子血压计血压测量结果整体高于汞柱式血压计,但是两者之间差异不显著,由于臂式电子血压计测量操作更加简单方便,易于携带。     

Validation of a method of blood pressure measurement for a study of hypertension in a black African population

Hypertension is a major public health issue in Black Africa. It is also an important factor of cardiovascular risk. To determine the prevalence of hypertension in a large population in Burkina Faso, it is more practicable to use an automatic device for the measurement of BP. Before the start of the study, we tested the reliability of an automatic technique for the measurement of BP in sitting position according to the reference technique. The manometer of reference was a manual, aneroid, and calibrated manometer. The automatic manometer was oscillometric, validated according to the protocol of the British Hypertension Society. The study was held on voluntary healthy persons, or patients hospitalized in the cardiology department of the national university hospital of Ouagadougou (high blood pressure, valvulopathy, cardiac insufficiency). BP measurement was made in a sequential way, with the manual manometer, and with the automatic manometer, by a single observer. Measurement by the manual manometer was based on the auscultation of Korotkoff's murmurs. Systolic blood pressure (SBP) corresponded to phase I, and diastolic blood pressure (DBP) to phase V. Measurement by the automatic manometer was made by reading the BP shown on the device screen. The 10.0 version of the SPSS software was used for data analysis. Statistical tests were concluded with a risk of 0.05. Confidence intervals included 95% of the subjects. The percentage comparison of hypertensive subjects observed in the population by both methods was made with a paired khi2 test. We used Pearson's correlation to quantify the relation between the measures taken using the two methods. In order to quantify the degree of agreement of the two methods, we used the intraclass correlation coefficient (ICC) for quantitative BP measurements, and Kappa's coefficient for qualitative measurements (determination of normotensive or hypertensive subjects). The study was held on 50 black African subjects, with the average age of 38.54 4.83 (18 years-77 years); 55% were male subjects. With the reference method in the sleeping position, the mean SBP and DBP values were respectively 122.60 8.52 and 70.36 5.22 mmHg. The minimal and maximal SBP observed were 80 and 240 mmHg respectively, and the DBP, 30 and 130 mmHg respectively. With the automatic method in the sitting position, the mean values SBP and DBP was 119.88+7.50 and 74.80 4.36 mmHg. SBP minimal was of 75, the maximal of 210 mmHg, and the minimal and maximal DBP was respectively 51 and 121 mmHg. Pearson's correlation coefficients for SBP and DBP between the two methods were statistically different from zero; 0.92 (p<0.001), and of 0.82 (p<0.001) respectively. The ICC was 0.91 for SBP and 0.78 for DBP. Kappa's coefficient was calculated to estimate agreement for the determination of normotensive or hypertensive subjects; among the 50 subjects, 36 were classified normotensive by the two methods, and eight, hypertensive. The differences of classification concerned five hypertensive subjects and one normotensive subject, according to the referenced method. Kappa's coefficient was 0.65. The distribution of the subjects in hypertensive and normotensive did not differ significantly in the two methods (p=0.22). The agreement between the two methods was found very good for the measurement of SBP and DBP; it was good for the determination of an hypertensive or normotensive subject. It is important to test the reliability of a technique of BP measurement before the evaluation of hypertension prevalence in a large population. The reliability of the technique ensures a good estimation of the disease prevalence. It is also important to use statistically adapted tests, to avoid any wrong conclusion as to the reliability of the technique.     

A unit for testing semiautomatic and automatic tools to measure blood pressure and heart rate

To test automatic and semiautomatic tools for measuring blood pressure and heart rate, the authors propose an automatic device that generates cuff pressure and compares it with reference pressure. Based on this comparison, an error of blood pressure measurement is calculated. Similarly, that of heart rate measurement is defined.     

无创性连续血压测量初探

本文介绍了一种通过红外光电式换能器,在桡动脉处测量血液容积,从而反映血压值大小的无创性连续血压测量方法。并通过试验结果分析,证明所测得的电量与血压值是线性相关的