直立倾斜试验760例的年龄和性别差异及护理对策

目的探讨直立倾斜试验（HUTT）的年龄和性别差异并制定护理对策。方法选择2001年1月-2008年3月在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因头晕、晕厥、头痛、胸闷受检者760例，男318例，女442例，年龄3．1～70．0岁，平均（21．7±15．7）岁，其中〈18岁464例（儿童组），≥18岁296例（成人组），分别进行HUTT检查并制定护理对策。结果（1）不同年龄、性别HUTT阳性率：760例HUTT受检者，HUTT阳性397例，阳性率为52．24％。成人组HUTT阳性率低于儿童组，差异有统计学意义（P〈0．05），儿童组男性低于女性，差异有统计学意义（P〈0．05），成人组未见性别差异（P〉0．05）。（2）不同年龄、性别出现HUTT阳性反应时间：在基础直立倾斜试验（BHUT）儿童组出现HUTT阳性反应时间小于成人组，差异有统计学意义［（21．8±10．4）min vs．（26．3±13．0）min］，P〈0．05）；在SNHUT儿童组与成人组差异无统计学意义（P〉0．05）。（3）晕厥发作时血流动力学明显变化出现卒：晕厥发作时心率≤40次／min者22例（2．89％），血压测不到者67例（8．82％）。（4）药物诱导副作用：舌下含化硝酸甘油496例，未见明显的不良反应。结论HUTT存在一定的年龄和性别差异，诱导晕厥发作存在一定风险，但密切观察HUTT阳性表现时的生命体征变化并及时采取有效护理措施是安全的，强调应重视儿童和女性HUTT表现快速多变的特点。

Differences of Head-up Tilt Test in Age and Gender and Nursing Strategy: A report of 760 cases

Objective To explore the age and gender differences of head-up tilt test (HUTT) and institute strategy of nursing. Methods Some 760 patients with unexplained dizziness, syncope, headache or chest distress, 318 males, 442 females, aged 3.1-70.0 with an average of (21.7±15.7), were enrolled in this study, of which 464 were younger than 18 years old (children group ), 295 were 18 years old or above (adult group). HUTT was performed in all patients and the strategy of nursing was instituted for each. Results (1)Among all the 760 patients, HUTT was found to be positive in 397 (52.24%). The positive rate was lower in adult group than in children group (P<0.05), and lower in males than in females in children group((P<0.05);No gender differences was found in adult group (P>0.05). (2)The time of HUTT positive reaction in children group was significantly shorter than that in adult group (21.8±10.4)min vs. (26.3±13.0)min] (P<0.05). There's no statistical differences between two groups in sublingual nitroglycerin head-up tilt table test (SNHUT) stage (P>0.05). (3)There were 22 (2.89%) patients whose heart rate ≤40/min and 67 (8.82%) whose blood pressure can not be measured. (4)Among 247 patients who took sublingual nitroglycerin administration, no significant adverse effect was found. Conclusion There were certain age and gender differences in HUTT. Some risk existed during inducing episode of syncope, but it was safe to observe vital sign change in HUTT-positive response and take up promptly effective nursing intervention. It should be emphasized to focus on the fast changing characteristics of HUTT performance in children and females.