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目的探讨老年高血压患者发生体位性低血压的血压昼夜节律变化特点,在临床护理中采取针对性措施,减少因体位性低血压引发的不良事件。方法对2016年1月-2017年1月期间在某院综合科住院的163例老年高血压患者进行卧位及立位3分钟血压监测。测量后分为高血压合并体位性低血压组(OH组n=24)及单纯性高血压组(非OH组n=139)。对两组患者均进行24小时动态血压监测,比较血压昼夜变化。结果两组白天平均收缩压、舒张压均无明显差异。OH组的夜间平均收缩压及舒张压均高于非OH组(P<0.05)。结论老年高血压合并体位性低血压患者存在夜间高血压及卧位高血压的特点。根据这一节律特点,某病房调整临床护理方案,以预防夜间直立后即刻体位性低血压发生而引起的不良事件。
Objective To investigate the changes of circadian rhythm of blood pressure in orthostatic hypotension in elderly patients with hypertension and to take targeted measures in clinical nursing to reduce the adverse events caused by orthostatic hypotension. Methods A total of 163 elderly patients with hypertension who were hospitalized in a department of general hospital from January 2016 to January 2017 were tested for lying position and standing blood pressure for 3 minutes. The patients were divided into hypertension group (n = 24 in OH group) and hypertension group (n = 139 in non-OH group). Two groups of patients were 24-hour ambulatory blood pressure monitoring, comparing changes in blood pressure day and night. Results The average systolic blood pressure and diastolic blood pressure in the two groups were not significantly different. Nighttime systolic and diastolic blood pressure were significantly higher in OH group than in non-OH group (P <0.05). Conclusions There are some characteristics of nocturnal hypertension and supine hypertension in elderly patients with orthostatic hypotension. According to the characteristics of this rhythm, a ward adjusted clinical nursing program to prevent adverse events caused by postural orthostatic hypotension at night.