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1、血壓、脈搏檢查黑龍江中醫(yī)藥大學(xué)診斷教研室 王艷芬血壓檢查BloodPressureU.S.DepartmentofHealthandHumanServicesNationalInstitutesofHealthNationalHeart,Lung,andBloodInstituteNationalHeart,Lung,andBloodInstitute NationalHighBloodPressureEducationProgramTheSeventhReportofthe JointNati
2、onalCommitteeon Prevention,Detection, Evaluation,andTreatmentofHighBloodPressure(JNC7)血壓檢查血壓動(dòng)脈血壓簡(jiǎn)稱血壓（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.血壓的測(cè)量方法直接測(cè)量法：將特制導(dǎo)管經(jīng)皮穿刺置于主動(dòng)脈內(nèi)，通過(guò)換能器讀取數(shù)據(jù)間接測(cè)量法：即袖帶加壓法血壓計(jì)：成人標(biāo)準(zhǔn)氣袖寬約12-13cm，手擘過(guò)于粗大或測(cè)大腿血壓氣袖增寬至20cm，兒童氣袖寬7-8cm。間接測(cè)量方法及步驟1、病人仰臥位，右上肢裸露并伸直輕度外展，肘部與心臟同一水平。2、袖帶縛于上臂，
7、袖帶下緣距肘彎?rùn)M紋上約2-3cm。3、聽(tīng)診器胸件置于肘窩肱動(dòng)脈上（不能壓在袖帶下面）。4、最高充氣壓的確定向袖帶內(nèi)充氣，邊充氣邊聽(tīng)診，待肱動(dòng)脈搏動(dòng)消失，再將汞柱升高20-30mmHg。間接測(cè)量方法及步驟5、收縮壓的確定：緩慢放氣，兩眼平視汞柱緩慢下降，按Korotkoff分期法，聽(tīng)到第一聲響的汞柱數(shù)值為收縮壓（第一期）。6、舒張壓的確定：最終聲響消失時(shí)的汞柱數(shù)值為舒張壓（第五期）。7、記錄：收縮壓/舒張壓mmHg如126/88mmHg。8、脈壓差：收縮壓-舒張壓9、平均動(dòng)脈壓：舒張壓加1/3脈壓
8、。血壓標(biāo)準(zhǔn)根據(jù)1999年10月中國(guó)高血壓聯(lián)盟參照了WHO/ISH指南（1999）公布的中國(guó)高血壓防治指南新標(biāo)準(zhǔn)，規(guī)定如下:BloodPressureClassificationNormal<120and<80Prehypertension120–139or80–89Stage1Hypertension140–159or90–99Stage2Hypertension>160or>100BPClassificationSBPmmHgDBPmmHgPurposeWhyJNC7?Publicationo
