体位对急性心肌梗死病人无创血压监测值的影响

目的探讨体位因素对急性心肌梗死(AMI)病人无创血压监测值的影响。方法将60例AMI病人不同体位的血压监测值进行自身对照比较,对数据进行统计学处理。结果左臂测压:右侧卧位时,收缩压与平卧位相比平均低1.97 kPa,舒张压与平卧位相比平均低1.55 kPa,(P<0.001),差别有显著意义;左侧卧位时,收缩压与平卧位相比平均高0.385 kPa,舒张压与平卧位相比平均低0.0147 kPa,差别无显著意义(P>0.05)。右臂测压:左侧卧位时,收缩压与平卧位相比平均降低1.74 kPa,舒张压与平卧位相比平均降低1.95 kPa,差别有显著意义,(P<0.001);右侧卧位时,收缩压与平卧位相比平均高0.489 kPa,舒张压与平卧位相比平均高0.496 kPa,差别无显著意义,(P>0.05)。结论侧卧位测压时,当测压手臂位于心脏同一水平线上方时所测得的血压值显著低于平卧位所测得的血压值,当测压手臂位于心脏同一水平线下方时所测得的血压值与平卧位相比差别无显著意义。     

体位对无创动态血压监测的影响

为了使血压测量准确,测血压限制体位,使被测肢体与心脏处于同一水平,但进行长时间无创动态血压监测（ABPM）时很难让患者做到持续性坐位或仰卧位。在病情允许的情况下,为探讨何种体位测量血压更准确,笔者检测了2003年3月～2006年4月住院患者338例仰卧位与侧卧位血压的变化,现将结果报告如下。     

休克患者有创血压与无创血压监测的对比与分析

为了探讨休克患者有创血压，无创血压二者间的关系，本文收集了８３名休克患者３８４次的测压对比与分析，结果表明：休克患者创血的的收缩压，舒张压，脉压差的均低于无创血压的各项值。     

成人有创血压及无创血压测量值的比较

目的：比较成人有创血压及无创血压同一时间段测量值的差异。方法：对20例成人患者进行l000次的血压监测，对同一病人存在的差异和20例病人的平均差值进行分析比较。结果：有创血压值不论是同一病人．还是20例病人均高于无创血压．并且收缩压差值比舒张压差值更明显，具有统计学意义（P〈0．01）。结论：在临床治疗和抢救病人时，应考虑有创血压和无创血压的差异性．特别是血压处于临界水平时，更应慎重。     

有创血压监测值与无创血压监测值相关性分析

目的 探讨有创血压监测值与无创血压监测值之间的线性关系,为临床血压监测提供参考.方法 选取ICU监测无创血压与有创血压的患者32例,采取自身对照的方法,同时监测患者有创血压及无创血压值,采集数据资料进行比较,并进行线性关系分析.结果 采集有效数据98对,所得数据有创血压收缩压及舒张压值分别为(146.93±21.426),(71.32±13.152) mm Hg,均高于无创血压值的(124.02±19.417),(68.86±15.251)mmHg,差异均有统计学意义(t分别为15.301,3.363;P＜0.05);有创血压与无创血压存在线性关系(r =0.880,P＜0.05).结论 有创血压与无创血压所得监测值之间有差异,不可相互替代,可使用无创血压监测值推导计算有创血压监测值.     

无创与有创血压测量的对比研究

目的 通过无创间接血压测量与有创直接血压测量两种不同方法的比较，探讨无创间接血压测量法反映患者真实血压的可靠性、误差及原因。方法 患者选自2003年12月至2004年5月期间在我院心导管室行心血管介入检查治疗的患者。同时应用无创及有创方法测量血压，并测量在上肢袖带缠绕处上臂周径，统计学处理后分析有创与无创血压的相关性及上臂周径对无创血压测量的影响。结果 水银柱式血压计测得的结果与真实血压相比SBP、DBP、PP均有统计学意义，SBP（P〈0．01）、DBP（P〈0．01）、PP（P〈0．01），两种测量方法测得的SBP差和DBP差与臂围均无显著相关性（P〉0．05）。结论 用水银柱式血压计测量的血压值与真实值有一定误差，上臂周径对无创血压测量无明显影响；本研究提示对于危重患者有条件的情况下应尽量进行有创血压监测。     

体位对无创动态血压监测的影响

为了使血压测量准确,测血压限制体位,使被测肢体与心脏处于同一水平[1],但进行长时间无创动态血压监测(ABPM)时很难让患者做到持续性坐位或仰卧位.在病情允许的情况下,为探讨何种体位测量血压更准确,笔者检测了2003年3月～2006年4月住院患者338例仰卧位与侧卧位血压的变化,现将结果报告如下.     

休克早期患者有创和无创血压监测的比较

目的对休克早期患者的有创和无创血压监测值进行对比分析,探讨休克患者血压监测的最佳方法。方法对56例休克早期患者选择同侧肢体动脉进行有创和无创血压监测,将所得数据进行统计分析。结果休克早期患者在早期(48 h内)有创血压明显低于无创血压,其差异有显著性意义,在后期(48 h后)两者无显著差异。结论休克早期患者,在早期(48 h)应采用有创血压监测,以提供更准确的依据,在后期(48 h后)可以用无创血压监测代替有创血压监测。     

休克患者有创血压与无创血压监测的对比与分析

为了探讨休克患者有创血压、无创血压二者间的关系，本文收集了８３名休克患者３８４次的测压对比与分析。结果表明：休克患者有创血压的收缩压、舒张压、脉压差均低于无创血压的各项值。     

Intra‐arterial blood pressure reading in intensive care unit patients in the lateral position

Background. Routine lateral turning of patients has become an accepted standard of care to prevent complications of immobility. The haemodynamic and oxygenation effects for patients in both lateral positions (45°) are still a matter of debate. We aimed to study the effect of these positions on blood pressure, heart rate and oxygenation in a general intensive care population. Design. Observational study. Method. Twenty stable intensive care unit patients had intra‐arterial blood pressure recordings in the supine and lateral positions with the correction of hydrostatic height compared with a fixed reference point (phlebostatic level). A multilevel model was used to analyse the data. Results. Mean arterial pressure readings in the lateral positions were, on average, 5 mmHg higher than in the supine position (p < 0·001). There were no significant differences between mean arterial pressure recordings in the left and right lateral position (p = 1·0). No important differences in oxygenation and heart rate were observed. After correction for covariates, the effects persisted. Conclusion. Our study demonstrated an increase, albeit small, in blood pressure in the lateral positions. No major differences between the left and right lateral position were found. No important differences in oxygenation and heart rate were observed. Relevance to clinical practice. Turning haemodynamically stable patients in the intensive care unit has no important effects on blood pressure measurements when continuous hydrostatic height correction is applied.     

侧卧位血压变化的研究

目的观察侧卧位时左右臂血压的变化。方法随机抽取50人进行平卧、左侧卧、右侧卧双上肢血压测量,对数据进行统计学处理。结果侧卧位双上肢血压有明显差异;平卧位双上肢血压无明显差异;左侧卧左上肢、右侧卧右上肢的收缩压与平卧位双上肢收缩压无明显差异。结论患者不得不侧卧位时,测血压应测位于下方的上肢,并标明体位及肢体。     

不同体位对血压测量值的影响

[目的 ]探讨不同体位对血压值的影响 ,以减少测量血压的误差 ,提高对疾病的诊断正确率。 [方法 ]对 90例基础血压正常的住院病人进行平卧位和坐位时血压值的测量。 [结果 ]不同体位对病人舒张压测量值的影响有统计学意义 (t =2 .5 46,P <0 .0 5 )。[结论 ]对需经常观察血压的病人应保持同一体位测量。     

有创血压监测的研究进展

近年来有创血压监测在危重症领域得到了广泛的应用，很多专家对此进行了大量的研究并取得了很大的进展，本文就此作一综述。     

直接血压与间接血压相关性的影响因素与假性高血压的关系

目的探讨直接血压与间接血压的相关性及其影响因素与假性高血压的关系.方法 208例临床需要行冠状动脉造影的患者,男150例,女58例,平均年龄(60.2±10.9)岁.在动脉穿刺成功后冠状动脉造影前同步测量直接血压和间接血压各3次,取平均值,造影结果由2位以上专家判断并记录.根据冠状动脉造影结果分为2组,冠状动脉正常组(104例)和冠心病组(104例).根据有无高血压病分为正常血压组(95例)和高血压病组(113例).并测量身高、体质量、臂围(AC)、腰围(WC)、臀围(HC),计算体质量指数(BMI)、腰围/臀围(WHR)、腰围/身高(WHtR)、平均血压(MBP)、直接与间接收缩压(SBP)差值(S-S)和直接与间接舒张压(DBP)差值(D-D).结果①直接血压与间接血压明显相关,SBP、MBP、DBP相关系数分别为0.88、0.76、0.58(P＜0.01).②高血压病组、冠心病组、女性直接SBP与间接SBP相关性好,而直接DBP与间接DBP相关性较差, SBP、MBP、DBP相关系数分别为0.52、0.48、0.49(P＜0.01).③直接血压总体上高于间接血压,S-S:-39～40 mm Hg(1 mm Hg=0.133 kPa),(6.35±12.50) mm Hg;D-D:-47～55 mm Hg,(5.63±11.17) mm Hg. S-S≤-10 mm Hg组与S-S＞-10 mm Hg组,S-S≤-10 mm Hg组的 AC、WC、HC、WHR、WHtR、BMI和年龄是更高的,仅BMI差别有统计学意义(P＜0.05).D-D ≤-10 mm Hg组与D-D＞-10 mm Hg比较,D-D ≤-10 mm Hg组 AC,WC,HC,WHR,WHtR 和BMI是更高的,仅AC差别有统计学意义(P＜0.05).分析AC与直接间接SBP、DBP的差值的关系发现:冠心病组AC与D-D相关,相关系数为0.27(P＜0.01).高血压组S-S与AC相关,相关系数为-0.22(P＜0.05).结论①直接血压与间接血压有明显相关性,其中SBP相关性最好,MBP次之,DBP最差(尤其是高血压病组、冠心病组和女性组);②AC是影响直接与间接血压测量值差值的重要因素,冠心病组AC影响DBP,而高血压病组AC影响SBP;③BMI高和AC大者易高估间接血压而出现假性高血压的情况.     

Changes in blood pressure in the sitting and standing positions in hypertensive patients

Ersoy S, Pinar R, Ersoy IH. International Journal of Nursing Practice 2011; 17 : 105–109 Changes in blood pressure in the sitting and standing positions in hypertensive patients Most guidelines for management of hypertension do not give special preference to a specific position of patient during blood pressure (BP) measurement, suggesting that BP readings taken with patients sitting, supine and standing are equivalent. The objective of this study was to examine whether there was any difference between BP readings with hypertensive participants comfortably sitting on chair and those with participants standing with the arm supported horizontally at the right atrial level. BP was measured twice each for 168 hypertensive patients (medicated and unmedicated) at sitting, standing and sitting positions, respectively, with a mercury‐filled column sphygmomanometer. We found significantly lower in systolic and diastolic BP readings in standing position than in sitting position. The present study indicates that the BP readings are related to the posture; thus, BP measured in different positions cannot automatically be regarded as equivalent.     

Portapres and differential oscillometric finger blood pressure changes during deep breathing test in the assessment of BRS index

The aim of this study was to investigate changes in the finger blood pressure during a deep breathing test (DB) and to find out whether the mean blood pressure might be used as a substitute for the systolic pressure in calculations of baroreflex sensitivity from data derived from the DB test. Continuous beat-to-beat finger pressure was recorded by the volume clamp method (Portapres model 2 monitor). In addition, the mean arterial pressure was recorded by the modified oscillometric method (UT9201 beat-to-beat monitor, University of Tartu, Estonia). Fifteen healthy volunteers, aged 25-56 years, were studied. The amplitude of respiration-linked oscillations in the Portapres systolic (Psyst) and mean blood pressure (Pmean) was 22.2 +/- 8.8 and 16.6 +/- 5.8 mmHg, respectively. There was no significant difference between the amplitudes of induced changes in Pmean recorded by the two devices: the amplitude of oscillations in the mean blood pressure recorded by the differential oscillometric monitor was 16.0 +/- 5.9 mmHg. The amplitude of oscillations in Psyst correlated significantly with the amplitude of oscillations in Pmean recorded either by Portapres or by UT9201 (r=0.95 and 0.98, respectively). The high correlation between the amplitudes of oscillations in mean and systolic blood pressure allows to conclude that mean arterial pressure changes during a DB test might be used instead of systolic pressure changes in calculation of the ratio of changes in pulse interval to changes in blood pressure, which is considered to reflect baroreflex sensitivity.     

人工机械瓣置换术后有创血压与无创血压监测的对照研究

目的探讨人工机械瓣置换术后有创动脉血压（ABP）与无创动脉血压（NBP）测量值的差异。方法对40例机械瓣置换术后24h患者进行有创和无创动脉血压监测比较,并对结果进行t检验。结果有创和无创动脉血压在术后早期（12h内）比较差异显著,12h以后比较无显著差异。结论机械瓣置换术后早期的有创血压与实际血压值有一定误差,采用有创血压监测,能更准确的反映血压的真实值,心内直视手术12h以后可以用无创血压监测替代有创血压监测。     

A comparison of differential oscillometric device with invasive mean arterial blood pressure monitoring in intensive care patients

Non‐invasive beat‐to‐beat mean arterial pressure (MAP) in finger arteries recorded by the differential oscillometric device was compared with MAP recorded invasively from A. radialis in 22 patients after cardiac surgery. Based on all 132 paired measurements, the MAP values measured at the radial artery were 2.7 ± 4.9 mmHg higher than those measured on fingers. Among 22 patients there were 8 patients receiving inotropic support, their difference being 2.1 ± 5.6 mmHg. The present study revealed that the mean discrepancy between the invasive radial pressure and finger pressure was small; however, patient data sets showed marked variability in average pressure differences when examined individually.