动态血压监测下对原发性高血压病病人护理干预效果评价

[目的]探讨护理人员应用“时间治疗学理论”对原发性高血压病病人实施护理干预的效果。[方法]自行设计问卷，对72例原发性高血压病病人进行问卷调查；在动态血压监测下对干预组实施以“时间治疗学理论”为指导的护理干预。[结果]干预后干预组病人在血压监测、服药时间、服药、饮食、运动5个维度的治疗行为以及对血压的控制明显优于干预前。[结论]在动态血压监测下，以“时间治疗学理论”为指导对原发性高血压病病人进行护理干预，能够有效地提高原发性高血压病病人治疗依从性和控制高血压。     

动态血压监测下对原发性高血压病病人护理干预效果评价

[目的]探讨护理人员应用"时间治疗学理论"对原发性高血压病病人实施护理干预的效果.[方法]自行设计问卷,对72例原发性高血压病病人进行问卷调查;在动态血压监测下对干预组实施以"时间治疗学理论"为指导的护理干预.[结果]干预后干预组病人在血压监测、服药时间、服药、饮食、运动5个维度的治疗行为以及对血压的控制明显优于干预前.[结论]在动态血压监测下,以"时间治疗学理论"为指导对原发性高血压病病人进行护理干预,能够有效地提高原发性高血压病病人治疗依从性和控制高血压.     

社区高血压病人服药依从性的影响因素与护理干预

目的:分析社区307例Ⅰ～Ⅲ级高血压病人服药依从性差的因素,并提出提高高血压病人服药依从性的干预措施。方法:采用自行编制的高血压病人依从性问卷,对307例高血压病人进行入户调查,分析其服药依从性差造成血压控制不理想的主要因素。结果:对高血压病危害性、严重性认识不足,药物的不良反应及健康教育措施未充分落实,社区及家庭支持系统不足等是影响病人服药依从性差的主要因素。结论:对病人加强健康教育,完善社区及家庭支持系统,选择个体化用药,减少药物不良反应,定期测量血压,加强随访是提高病人服药依从性、有效控制高血压的主要措施。     

运用时间治疗学理论实施护理干预对原发性高血压患者药依从性的影响

目的:探讨运用时间治疗学理论实施护理干预对原发性高血压患者服药依从性及治疗效果的影响.方法:对68例原发性高血压患者及家属实施健康教育,根据患者血压变化规律,在给药时间、给药剂量等方面实施护理干预,并对干预前后患者服药依从性进行调查,观察其血压控制情况.结果:实施护理干预后患者服药依从性 和血压控制情况与干预前比较有显著性差异(P<0.05).结论:运用时间治疗学理论对原发性高血压患者进行护理干预,可提高患者服药依从性,有效控制患者的血压水平.     

运用时间治疗学理论实施护理干预对原发性高血压患者服药依从性的影响

目的：探讨运用时间治疗学理论实施护理干预对原发性高血压患者服药依从性及治疗效果的影响。方法：对68例原发性高血压患者及家属实施健康教育，根据患者血压变化规律，在给药时间、给药剂量等方面实施护理干预，并对干预前后患者服药依从性进行调查，观察其血压控制情况。结果：实施护理干预后患者服药依从性和血压控制情况与干预前比较有显著性差异（P〈0．05）。结论：运用时间治疗学理论对原发性高血压患者进行护理干预，可提高患者服药依从性，有效控制患者的血压水平。     

运用时间治疗学对社区原发性高血压病病人降压疗效的影响

[目的]探究应用时间治疗学实施护理干预对社区原发性高血压病痛人降压疗效的影响。[方法]对57例社区原发性高血压病痛人实施护理干预,根据病人血压变化规律,在给药时间、给药剂量等方面制订个体护理方案,对干预前后血压值进行比较,观察降压疗效。[结果]原发性高血压病病人实施护理干预前后降压疗效比较,差异有统计学意义（P〈0．05）。[结论]运用时间治疗学对社区原发性高血压病病人实施护理干预可提高降压疗效,有效控制血压。     

健康教育对高血压病人遵医行为的影响

由于人们对高血压病危害认识不足,使高血压病呈现发病率高、死亡率高、致残率高和病人对高血压病的知晓率低、治疗率低、血压控制率低的特点。其中高血压病人服药依从性低是血压控制不好的主要原因之一,高血压的控制不仅要选择有效的降压药物,更需要有良好的遵医行为。为提高高血压病人的相关知识知晓率和遵医行为,我院2007年9月-2008年8月对136例高血压病人实施健康教育,取得满意效果,现报道如下。     

家庭血压自测的护理干预对社区高血压病病人服药依从性的影响

[目的]探讨家庭血压自测的护理干预对社区高血压病病人服药依从性的影响。[方法]回顾性分析社区卫生服务中心206例高血压病病人行家庭血压自测护理干预的临床资料。[结果]病人的服药依从性由干预前的49.51%提高到81.55%,血压达标率由护理干预前的30.10%提高到70.39%(P<0.05)。[结论]家庭血压自测的护理干预可提高病人的服药依从性、改善病人的收缩压及舒张压。     

健康教育在高血压病人护理中的应用

[目的]提高高血压病人的服药依存性及生活质量,减少心、脑、肾并发症的发生。[方法]对178例高血压病人进行心理指导、饮食及生活方式指导、用药指导、自测血压指导、家属指导及跟踪教育。[结果]178例高血压病人经过健康教育掌握了高敌国压的相关知识,提高了服药依从性及生活质量,随访无一例出现并发症。[结论]健康教育可有效提高高血压病人服药依从性及生活质量,减少心、脑、肾并发症的发生。     

高血压病患者居家服药依从性的现状调查及护理干预

目的 探讨居家服药依从性和护理干预对高血压患者血压控制的影响.方法 问卷调查139例高血压患者的一般状况、卫生保健知识、居家药物治疗依从性和进行健康宣教、制定合理的用药方案、自测血压、制作提醒系统及强化社会支持网络等护理干预,再进行第二次资料收集,然后进行Logistic回归分析.结果 护理干预后高血压病人居家服药依从...     

老年高血压病患者停服降压药物的原因分析

目的为了调查老年高血压病患者停服降压药物的原因,以提高老年高血压患者的治疗效果.方法采用面谈和查阅患者病历的方法,调查115例高血压病患者停服降压药物的原因及其动态血压检测结果,然后进行数据统计和分析.结果 115例停服降压药物的原因分别为多次测量血压偏低、对高血压病了解不够、对降压药物了解不够、服药方案过于复杂、老年患者记忆力较差、一时配不到同种药物,其中因血压偏低而停药患者(血压控制率为77.35%)与因其他原因而停药患者(血压控制率为33.87%)比较,差异有统计学意义(P＜0.001).结论对患者加强健康教育,定期检测血压,以提高血压控制率.     

不同速度静脉给药对心内直视术后病人血压影响的观察

目的 :为了解氟哌利多和枸橼酸芬太尼合剂从小壶给药和直接静脉注射对心内直视术后病人血压的影响。方法 :随机抽取我院心外科2 0 0 0年 10月 10日至 2 0 0 1年 3月 30日实施心内直视术后血液动力学稳定的病人2 0例 ,对每位病人分别采用小壶和直接静脉注射氟哌利多和枸橼酸芬太尼合剂镇静 ,观察病人血压下降情况。结果 :小壶给药时病人血压下降到最低值所需时间长 ,血压下降的幅度小 ,血压回升至给药前水平所需时间短 ,经配对t检验 ,有统计学意义 (P <0 .0 0 1)。结论 :心内直视术后病人采用氟哌利多和枸橼酸芬太尼合剂镇静时从小壶给药比直接静脉注射安全     

Comparison of effects of darbepoetin alfa and epoetin alfa on serum endothelin level and blood pressure

It is well known that epoetin alfa increases serum endothelin (ET)-1 and blood pressure. No data are available, however, on the effects of darbepoetin alfa on serum ET-1 and blood pressure. This study was conducted to compare the effects of darbepoetin alfa and epoetin alfa on serum ET-1 and blood pressure in patients on hemodialysis (HD). A total of 42 patients on HD were included in the study. Serum samples for measuring levels of ET-1 were taken 30 min after administration of epoetin alfa. After blood samples had been taken from all patients, epoetin alfa was changed to darbepoetin alfa. Three months after the start of darbepoetin alfa treatment, blood samples were taken to measure the same parameters. Mean arterial blood pressure was measured before recombinant human erythropoietin (EPO) administration and 30 min after EPO administration while patients were taking epoetin alfa or darbepoetin alfa. Injection of epoetin alfa or darbepoetin alfa significantly increased serum ET-1 levels compared with levels in those patients who were not on EPO therapy (P < .05). When the effects of epoetin alfa on serum ET-1 level were compared with those of darbepoetin alfa, the 2 types of EPO were found to increase serum ET-1 levels similarly (P > .05). Administration of epoetin alfa or darbepoetin alfa increased systolic and diastolic blood pressures significantly over values in the control group (P < .05). Serum systolic and diastolic blood pressures increased similarly after injection of epoetin alfa or darbepoetin alfa. Administration of darbepoetin alfa increased blood pressure in patients on HD in a way that was positively correlated with enhanced ET-1 release; a similar correlation was noted with epoetin alfa.     

Study of the influence of the time of administration on the antihypertensive effect and nitrendipine tolerance in mild to moderate essential hypertensive patients. Value of ambulatory recording of blood pressure on 24 hours]

Forty-one patients with mild to moderate hypertension were included in a multicentre trial. The objective was to assess the influence of the time at which nitrendipine (Nidrel 20 mg) is taken on its efficacy and tolerance. The drug was administered once daily either in the morning or in the evening during 2 consecutive periods of 28 days. Efficacy was assessed on an ambulatory recording of blood pressure over 24 hours. Globally, nitrendipine results in a statistically significant drop in blood pressure which is not influenced by the time of administration. Treatment response varies greatly according to the initial value of ambulatory diastolic blood pressure. There is a clear antihypertensive effect if ADBP is greater than or equal to 90 mmHg and no hypotensive effect if ADBP is less than 90 mmHg. The incidence of adverse effects did not vary according to the time the drug was taken. Biological tolerance was excellent. Nitrendipine, administered once daily alone appears to be an efficient antihypertensive agent, well tolerated both clinically and biologically. Its efficacy is maintained over a 24-hour period regardless of the time at which the drug is taken.     

Efficacy and safety of nicardipine in 29,104 patients with hypertension

The efficacy and safety of nicardipine were assessed in 29,104 hypertensive patients (mean age, 64 years) during a 90-day multicenter clinical trial. By treatment day 90, blood pressure was controlled in 60% of the patients taking nicardipine alone. The efficacy of nicardipine combined with another antihypertensive agent was examined in 6,479 of the patients. When nicardipine was added to their treatment regimen, blood pressure was controlled by day 90 in 63% of the patients taking beta-blockers, in 58% of those on diuretics, in 50% of those on angiotensin converting enzyme inhibitors, and in 49% of those taking centrally acting antihypertensive agents. Nicardipine was well tolerated; only 11% of the 29,104 patients discontinued treatment because of side effects. Most adverse reactions were transient and were related to vasodilation, and included peripheral edema in 7% of the patients, flushing in 7%, and headache in 4%. The results indicate that nicardipine is suitable as initial therapy in arterial hypertension.     

Clinical evaluation of urapidil, a new antihypertensive drug: preliminary findings in Japan

The pharmacokinetics, hypotensive effects, and safety of urapidil were investigated in 22 patients with essential hypertension at four coordinated centers in Japan. The drug was administered in sustained-release capsules given twice daily. The peak plasma concentration of the drug (measured in six patients) was observed four to six hours after administration, and 60% to 70% of the peak concentration was detectable at eight hours. These findings suggest that blood pressure might be controlled by twice-daily administration of urapidil. In 14 outpatients, who received 40 to 80 mg/day of urapidil, systolic and mean blood pressure decreased significantly (P less than 0.05) by week 4, and systolic, diastolic, and mean blood pressure decreased significantly (P less than 0.001) by week 6. In four inpatients, treated with 60 to 120 mg/day of the drug for two weeks, there were significant decreases (P less than 0.05) in systolic, diastolic, and mean blood pressure at day 6 and significant decreases (P less than 0.01) in diastolic and mean blood pressure at day 13. Although side effects were noted in five (23%) of the 22 patients, they were transient and slight in three; in two patients, the side effects disappeared after use of the medication was discontinued. Because the study was carried out in a small number of patients who received different dosages of urapidil over a short period of time, the optimal dosage was not established.     

Comparison of bisoprolol and verapamil in hypertension: influence on left ventricular mass and function--a pilot study.

The objective of this study was to test the influence of bisoprolol and verapamil on left ventricular filling in hypertensive patients in a 6 month randomized, double-blind trial in 54 hypertensive patients not previously treated with beta-blockers or calcium inhibitors. After administration of placebo for 14 days, an M echocardiogram of the left ventricle was recorded to determine left ventricular mass. Blood flow was evaluated by pulsed Doppler sonography. After randomization into two groups, one group received 10 mg of bisoprolol and the other 240 mg of verapamil LP in a single dose in the morning. After 2 months' treatment, the patients whose blood pressure was not well controlled were given a diuretic. Echo-Doppler was performed again by the same operator after 4-10 days on active treatment, after 6 months and after a subsequent 2 weeks of placebo for the patients treated with a single drug. The reduction in blood pressure was comparable in the two treated groups, but there was no significant decrease in left ventricular mass. Left ventricular filling was improved only in the patients receiving bisoprolol. The effect was observed immediately after the first administration and throughout the 6 months' treatment period declining slowly during the placebo wash-out. This effect appeared to be independent of any alteration in heart rate and was thought to be a specific action of this drug.     

A double-blind, randomized, crossover assessment of blood pressure following administration of avitriptan, sumatriptan, or placebo to patients with mild to moderate hypertension

We examined the effects of avitriptan, a 5-hydroxytryptamine 1-like (5HT1) receptor agonist for the treatment of migraine, in patients with medicated, controlled, mild to moderate hypertension relative to placebo and sumatriptan. The study was randomized, double-blinded, placebo-controlled, and 4-way crossover in design. Twenty patients (12M, 8F) participated. As required by protocol, all were stable on medications for mild to moderate hypertension, with a supine diastolic blood pressure of < 95 mmHg. Qualified subjects were randomized to receive oral administration of either 75 or 150 mg of avitriptan, 100 mg sumatriptan or placebo during the four treatment visits. Supine blood pressure and pulse rates were recorded up to 24 h after drug administration. Avitriptan 150 mg significantly increased peak diastolic and systolic blood pressure, and mean arterial pressure compared to placebo and sumatriptan 100 mg (p < 0.05). Only those hypertensive patients receiving medication for hypertension should receive anti-migraine medications, such as avitriptan, which are 5HT1-like receptor agonists.     

青壮年高血压患者遵医行为现状调查

目的 了解青壮年高血压患者遵医行为的现状.方法 采用自行设计的问卷对青壮年高血压患者在服药、饮食、睡眠、运动、自我监测、寻求健康帮助等方面情况进行调查.结果 青壮年高血压患者遵医行为不佳,主要表现在以下方面：不注重运动,不能做到定时、定量运动;近半患者不能按时、按量、按种类服药;大多患者没有定期到医疗单位监测血压和自我监测症状.本组患者三餐规律、食量适中遵医行为较好.结论 应加强对青壮年高血压患者的健康宣教,积极创造条件,改进青壮年高血压患者的遵医行为,从而提高患者远期的生活质量和健康水平.     

不同给药时间对非勺型高血压患者降压效果的影响

目的对高血压患者不同服药时间进行研究和护理干预,观察给药时间与血压昼夜节律是否相关,以探讨合理的高血压患者给药时间。方法选择高血压病住院患者共58例,随机分为两组,分别在6：00～7：00、20：00～21：00服药,监测24h动态血压。结果清晨或夜间服药均能有效降低24h平均血压。夜间给药组夜间SBP和夜间DBP显著低于清晨给药组,清晨时段SBP或DBP显著低于清晨服药组。结论通过选择恰当的给药时间,可逆转异常的昼夜血压节律,有效抑制清晨时段血压的迅速上升,降低心脑事件的发生率。