Influencing factors and nursing enlightenment of ankle-arm systolic pressure difference in hemodialysis patients
Objective To investigate the difference of systolic blood pressure between ankle and upper arm and its influencing factors in hemodialysis patients,and provide references for the evaluation of hemodialysis patients.Methods A total of 231 maintenance hemodialysis patients were selected by convenient sampling method from June to November 2023 in the blood purification center of a tertiary A general hospital in Wuhan,Hubei Province.The patients'medical records and the general situation were consulted through the hospital electronic medical record system,including gender,age,hemodialysis age,vascular access type,disease history,laboratory indicators and imaging data.The height,weight,water retention,upper arm blood pressure and ankle blood pressure were measured by 2 trained nurses using measuring tools validated by international standards.Multiple linear regression was used to analyze the difference between ankle and upper arm systolic blood pressure and its influencing factors.Results A total of 204 hemodialysis patients completed the investigation.The difference of ankle-arm systolic blood pressure(ankle blood pressure-arm blood pressure)in hemodialysis patients was(19.97±13.43)mmHg(1 mmHg=0.133 kPa).The results of multiple linear regression analysis showed that gender,water retention,history of cardiovascular dis-ease and history of cerebral infarction were the influencing factors of ankle-arm systolic blood pressure difference in hemodialysis patients,which could predict 28.70％variation.Conclusion In clinical nursing practice,the measure-ment of ankle-arm blood pressure should be included in the regular examination of hemodialysis patients.Nurses should strengthen health education for patients with high ankle-arm systolic blood pressure difference and guide pa-tients to control water intake during the dialysis period.The condition of patients with low ankle-arm systolic blood pressure difference should be evaluated;the high-risk factors leading to cardiovascular and cerebrovascular diseases should be screened;patients should be guided to improve relevant examinations,and intervenes should be conducted early to reduce the occurrence of cardiovascular events and cerebral infarction.
HemodialysisBlood PressureRoot Cause AnalysisNursing Care
万方数据
维普
