综合护理干预预防老年体位性低血压的效果

Effect of comprehensive nursing intervention on preventing elderly orthostatic hypotension

目的探讨综合护理干预对老年体位性低血压的防控效果。方法对334例老年男性进行问卷调查，根据是否发生体位性低血压将其分为体位性低血压组和非体位性低血压组，比较两组患者一般情况及合并的临床疾病的情况。对97例体位性低血压患者进行综合护理干预和随访，比较干预前后体位性低血压知晓率、测量立卧位血压频率及症状发生率。结果两组患者BMI、腰臀比、立位心率、CHO、TG、LDL-C、HDL—C、血糖值比较，差异均无统计学意义（P〉0．05）；体位性低血压组患者与非体位性低血压组患者比较，年龄大、卧位心率慢、卧位血压高、立位血压低、肌酐高，同时体位性低血压组患者合并高血压病、冠心病、脑卒中的发生率明显高于非体位性低血压组，差异均有统计学意义（P〈0．05）；体位性低血压组患者干预后体位性低血压知晓率、测量立卧位血压频率分为别81．4％，47．4％，均明显高于干预前的3．1％，5．2％，差异均有统计学意义（x2分别为122．01，44．72；P〈0．01）；干预后症状发生率为5．2％，低于干预前的15．5％，差异有统计学意义（x2=5．58，P〈0．05）。结论体位性低血压在老年人中发生率高，综合护理干预措施能提高体位性低血压的知晓率，降低症状发生率。

Objective To observe the effect of comprehensive nursing intervention on preventing orthostatic hypotension（OH） in the elderly. Methods Questionnaire was used to interview 334 elderly men, who were classified into groups with and without OH, and general and clinical situation were compared. Comprehensive nursing intervention and follow-up were carried out on 97 OH patients, the awareness rate of OH, the frequency of orthostatic hypotension measurement and the incidence rate of symptoms were compared before and after the intervention. Results The differences of BMI, waist-hip ratio, standing heart rate, CHO, TG, LDL-C, HDL-C and blood sugar level between two groups were not statistically significant （P 〉 0.05 ）. Compared to the patients without OH, OH patients were older, their lying heart rate was slower, lying blood pressure was higher, standing blood pressure was lower and creatinine was higher. In the meantime, the incidence rate of high blood pressure, coronary heart disease and stroke of patients with OH was obviously higher than that of the patients without OH, and the difference was statistically significant （ P 〈 0.05 ）. The OH patients＇ awareness of OH and frequency of orthostatic hypotension measurement were 81.4% and 47.4% after the intervention, much higher than those betore the intervention （3.1% and 5.2% ）, and the differences were statistically significant （ x2 = 122.01,44.72, respectively;P 〈 0.01 ）. The incidence rate of symptoms after the intervention was 5.2% , while that before the intervention was 15.5%, and the difference was statistically significant （ x2 = 5. 58, P 〈 0. 05 ）. Conclusions Orthostatic hypotension often occurs in elderly people. Comprehensive nursing intervention measures can improve the rate of awareness and reduce the incidence of symptoms of patients with orthostatic hypotension.