血压、脉搏检查方法研讨.ppt

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1、血压、脉搏检查黑龙江中医药大学诊断教研室王艳芬血压检查BloodPressureU.S.DepartmentofHealthandHumanServicesNationalInstitutesofHealthNationalHeart,Lung,andBloodInstituteNationalHeart,Lung,andBloodInstituteNationalHighBloodPressureEducationProgramTheSeventhReportoftheJointNati

2、onalCommitteeonPrevention,Detection,Evaluation,andTreatmentofHighBloodPressure(JNC7)血压检查血压动脉血压简称血压（BloodPressure,BP）BPMeasurementTechniquesMethodBriefDescriptionIn-officeTworeadings,5minutesapart,sittinginchair.Confirmelevatedreadingincontralateral

3、arm.AmbulatoryBPmonitoringIndicatedforevaluationof“white-coat”HTN.Absenceof10–20%BPdecreaseduringsleepmayindicateincreasedCVDrisk.Self-measurementProvidesinformationonresponsetotherapy.Mayhelpimproveadherencetotherapyandevaluate“white-coat”HTN.Self-M

4、easurementofBPProvidesinformationon:ResponsetoantihypertensivetherapyImprovingadherencewiththerapyEvaluatingwhite-coatHTNHomemeasurementof>135/85mmHgisgenerallyconsideredtobehypertensive.Homemeasurementdevicesshouldbecheckedregularly.OfficeBPMeasurem

5、entUseauscultatorymethodwithaproperlycalibratedandvalidatedinstrument.Patientshouldbeseatedquietlyfor5minutesinachair(notonanexamtable),feetonthefloor,andarmsupportedatheartlevel.Appropriate-sizedcuffshouldbeusedtoensureaccuracy.Atleasttwomeasuremen

6、tsshouldbemade.Cliniciansshouldprovidetopatients,verballyandinwriting,specificBPnumbersandBPgoals.血压的测量方法直接测量法：将特制导管经皮穿刺置于主动脉内，通过换能器读取数据间接测量法：即袖带加压法血压计：成人标准气袖宽约12-13cm，手擘过于粗大或测大腿血压气袖增宽至20cm，儿童气袖宽7-8cm。间接测量方法及步骤1、病人仰卧位，右上肢裸露并伸直轻度外展，肘部与心脏同一水平。2、袖带缚于上臂，

7、袖带下缘距肘弯横纹上约2-3cm。3、听诊器胸件置于肘窝肱动脉上（不能压在袖带下面）。4、最高充气压的确定向袖带内充气，边充气边听诊，待肱动脉搏动消失，再将汞柱升高20-30mmHg。间接测量方法及步骤5、收缩压的确定：缓慢放气，两眼平视汞柱缓慢下降，按Korotkoff分期法，听到第一声响的汞柱数值为收缩压（第一期）。6、舒张压的确定：最终声响消失时的汞柱数值为舒张压（第五期）。7、记录：收缩压/舒张压mmHg如126/88mmHg。8、脉压差：收缩压-舒张压9、平均动脉压：舒张压加1/3脉压

8、。血压标准根据1999年10月中国高血压联盟参照了WHO/ISH指南（1999）公布的中国高血压防治指南新标准，规定如下:BloodPressureClassificationNormal<120and<80Prehypertension120–139or80–89Stage1Hypertension140–159or90–99Stage2Hypertension>160or>100BPClassificationSBPmmHgDBPmmHgPurposeWhyJNC7?Publicationo