透析高血压患者的动态血压监测及护理观察研究

Ambulatory Blood Pressure Monitoring and Nursing Observation and Study of HD Hypertension Patients

未被理想控制的高血压是透析病人长期存活的主要威胁。为了熟悉其变化规律 ,对 44例透析高血压患者进行了动态血压监测及护理观察研究 ,发现 :(1)透析高血压多以收缩压升高为主 ,透析程序中血压升高较透析间期为甚 ;(2 )血压波动规律 ,收缩压在透析程序中于穿刺、进食、回血时呈现 3个小高峰 ,引血、回血前 30min略趋下降 ,回血后 2～ 4h呈较高趋势 ,舒张压总体波动较平坦 ;(3)血压昼夜节律变化基本消失 ;(4 )透析时的血压波幅、间期的平均动脉压均与左室重量指数呈显著正相关。

Uncontrolled hypertension is the major threat to survival rate of hemodialysis patients.In order to be familiar with blood pressure changing rhythm,with monitoring the ABp and nursing observation in 44 HD hypertension patients.We found:(1)systolic Bp was obviously high,Bp was higher during dialysis than no-dialysis period;(2)three peak of systolic Bp appeared when eating,fistula puncture and blood returning,but SBp slightly decreased half an hour later after blood drawing and returning and increased 2～4 hours later after blood returning.Generally DBp fluctuated slightly.(3)Bp fluctuation rhythm in day and night disappeared;(4)the extent of Bp fluctuation during dialysis and MAP during no-dialysis period were positively correlative with LVMI.