CAJ | 학술논문

目的：探讨四肢血压测量在急诊分诊中的意义。方法选择2012年7月-2013年6月急诊科就诊的血压异常患者共258例为研究对象，应用汞式血压计测量四肢血压，并计算踝臂血压指数，踝臂血压指数<0．9或踝臂血压指数>1．3为异常组，0．9≤踝臂血压指数≤1．3为正常组，追踪两组临床诊断。结果左侧上肢的收缩压、舒张压与右侧上肢的收缩压、舒张压比较，左侧下肢的收缩压、舒张压与右侧下肢的收缩压、舒张压比较，差异均无统计学意义，患者下肢收缩压比同侧收缩压高（10.8±2.3）和（10.9±3.1）mmHg，舒张压差距较小（1.4±0.8）和（2.0±0.9）mmHg。左侧上肢收缩压比右侧上肢高（>5 mmHg）者占29.0％，右侧上肢收缩压比左侧上肢高者占23.7％；左侧上肢舒张压比右侧上肢高（>5 mmHg）者占25.6％，右侧上肢舒张压比左侧上肢高者占19.0％，差异均无统计学意义，下肢血压与上肢血压统计结果相似，也无统计学意义。踝臂血压指数异常组诊断主动脉夹层13例，正常组诊断主动脉夹层3例，经比较差异有统计学意义（字2=160.1103，P=0.0001）。结论四肢血压测定便于更为精确地获取患者的血压值，从而提高对高血压的诊断水平，能识别血管事件的高危人群，早期发现潜在威胁生命的疾病。
목적：탐토사지혈압측량재급진분진중적의의。방법선택2012년7월-2013년6월급진과취진적혈압이상환자공258례위연구대상，응용홍식혈압계측량사지혈압，병계산과비혈압지수，과비혈압지수<0．9혹과비혈압지수>1．3위이상조，0．9≤과비혈압지수≤1．3위정상조，추종량조림상진단。결과좌측상지적수축압、서장압여우측상지적수축압、서장압비교，좌측하지적수축압、서장압여우측하지적수축압、서장압비교，차이균무통계학의의，환자하지수축압비동측수축압고（10.8±2.3）화（10.9±3.1）mmHg，서장압차거교소（1.4±0.8）화（2.0±0.9）mmHg。좌측상지수축압비우측상지고（>5 mmHg）자점29.0％，우측상지수축압비좌측상지고자점23.7％；좌측상지서장압비우측상지고（>5 mmHg）자점25.6％，우측상지서장압비좌측상지고자점19.0％，차이균무통계학의의，하지혈압여상지혈압통계결과상사，야무통계학의의。과비혈압지수이상조진단주동맥협층13례，정상조진단주동맥협층3례，경비교차이유통계학의의（자2=160.1103，P=0.0001）。결론사지혈압측정편우경위정학지획취환자적혈압치，종이제고대고혈압적진단수평，능식별혈관사건적고위인군，조기발현잠재위협생명적질병。
Objective To explore the effect of extremity blood pressure measurement in emergency triage and its significance. Methods From July 2012 to June 2013, totally 258 patients in emergency department with abnormal blood pressure were included in the study and mercury sphygmomanometer was applied for the measurement of their limb blood pressure, then the ankle-brachial pressure index (ABI) value was calculated. Patients with ABI value<0.9 or >1.3 were included into one group, while those with ABI value between 0.9 and 1.3 into another group. Patients ’ clinical diagnosis were traced. Results There were no statistical significances in the comparison between systolic and diastolic blood pressure left and right upper arm and between left and right lower limbs. Among patients with abnormal ABI value, totally 13 cases were diagnosed as aortic dissection and 3 cases were diagnosed as aortic dissection with normal ABI value. The difference was statistically significant ( P<0.01). Conclusion In the emergency triage, it is simple and convenient while effective to take extremity blood pressure measurement which offers accurate blood pressure value that helps to improve the diagnosis of hypertension and antihypertensive treatment as well as better guidance prognosis. ABI index in emergency department can help to identify high risk of vascular events and predict cardiovascular events.