老年高血压患者的家庭护理

随着现代生活水平的提高和社会压力的增加,高血压的发病率也在逐年增加,目前全国成人高血压患者约有1.6亿[1]。研究显示,通过有效地护理而控制血压是减少心脑血管事件的重要措施[2]。老年高血压患者,在血流动力学、临床特点及预后等方面都不同于其他年龄的高血压患者,积极有效的护理干预可增强高血压患者的服药依从性,提高临床疗效[3-4]。因此,采取积极有效的家庭护理对老年高血压患者是非常重要的。     

老年糖尿病综合护理干预研究进展

对老年糖尿病人开展多种形式的综合护理干预,有助于患者积极配合治疗,能有效提高患者治疗依从性,从而达到提高治疗效果、提升患者生活质量的目的。文章综述了近年来老年糖尿病综合护理干预的研究进展,为临床及家庭护理老年糖尿病提供一些参考。     

老年肺癌放疗患者的整体护理

目的探讨整体护理在老年肺癌放疗患者中的运用。方法针对老年肺癌放疗患者生理特点、生活习惯、心理状况、文化背景、知识结构、接受能力等情况制定整体护理方案。【结果]老年肺癌放疗患者对整体护理较为满意,提高了护理质量。[结论】对老年肺癌患者实施整体护理降低了并发症发生,提高了放射疗治效果,提升了老年肺癌放疗患者的生活质量。     

健康教育在老年高血压临床护理中的应用分析

目的:研究分析在老年高血压患者的临床护理中使用健康教育的效果。方法:选取本院2019年1月-2019年10月收治的84例的老年高血压患者作为研究对象,经患者同意后以患者编号作为分组依据把研究对象分为2组(各42例)。对照组给予患者常规护理,观察组在对照组常规护理的基础上给予患者健康教育,对两组患者的血压变化进行对比。结果:护理后观察组患者的血压数据优于对照组,且P0. 05,两组患者的数据差异对比具有统计学意义。结论:在老年高血压的临床护理过程中使用健康教育的护理效果显著,在增加患者疾病认知的同时对改善患者的血压数据具有积极性作用。     

老年高血压患者保健问题及其措施分析

目的对老年高血压患者保健问题进行探讨。方法将我院自2013年4月至2014年11月收治的120例老年高血压患者,分为对照组60例与观察组60例,对照组采用进行常规用药治疗,观察组采用在常规用药基础上加强老年高血压患者自身保健意识,观察两组患者的疗效。结果观察组治疗效果要优于对照组,两组比较差异具有统计学意义(P0.05)。结论对于老年高血压患者,采取保健意识护理措施,能够使患者血压得到有效控制,进一步为患者生活质量的改善提供依据。因此,值得在临床中推广及使用。     

家庭护理在老年高血压患者中的应用

目的：研究“以家庭为中心”的护理模式对缓解老年高血压患者的病情,促进老年高血压患者恢复以及缓解家庭焦虑的作用。方法：对老年高血压患者进行基础护理、生活护理、心理护理、健康教育以及健康指导。结论：家庭护理对老年高血压治疗效果明显。     

浅谈语言沟通技巧在护理老年患者中的重要性

目的总结语言沟技巧在护理老年患者时的经验。方法根据老年患者的疾病、生理及心理特点有计划并运用适当的方法进行语言沟通。结果丰富的专业知识、临床经验、亲切和蔼的态度及积极的语言能消除老年患者的顾虑,促进老年患者身心的康复。结论语言沟通具有可操作性和实用性。充分掌握语言沟通的技巧,可提高临床优质护理的质量,在针对老年患者的护理中起着举足轻重的作用。     

浅谈老年糖尿病人的家庭护理

目的：院提高老年糖尿病人家庭护理的质量和纠正病人不良的生活习惯,使其保持良好的心理状态,活动能力,促进康复治疗。方法院通过理论研究,在家庭中对老年患者进行心理护理,饮食治疗,运动疗法,用药指导,并发症的预防,随访与记录以及健康教育。结果院防止急性并发症的发生和减低慢性并发症的风险,对已经发生的并发症进行有效控制,提高患者生活质量,延长患者寿命。结论院积极有效的家庭护理得到老年患者和社会的认可,对老年糖尿病的治疗具有关键性的作用。     

浅谈老年糖尿病人的家庭护理

目的:提高老年糖尿病人家庭护理的质量和纠正病人不良的生活习惯,使其保持良好的心理状态,活动能力,促进康复治疗。方法:通过理论研究,在家庭中对老年患者进行心理护理,饮食治疗,运动疗法,用药指导,并发症的预防,随访与记录以及健康教育。结果:防止急性并发症的发生和减低慢性并发症的风险,对已经发生的并发症进行有效控制,提高患者生活质量,延长患者寿命。结论:积极有效的家庭护理得到老年患者和社会的认可,对老年糖尿病的治疗具有关键性的作用。     

自我管理行为干预对农村老年高血压患者血压和服药依从性的影响

目的探讨自我管理行为干预对农村地区老年高血压患者血压控制和提高患者服药依从性的效果。方法将160例农村老年高血压患者随机分为对照组和干预组各80例。对照组分发高血压防治宣传资料,干预组在此基础上接受自我管理行为干预。干预实施3个月后,比较两组患者血压变化和服药依从性的差异。结果护理干预3个月后,干预组的收缩压和舒张压都明显低于对照组,有统计学差异(P0.001)。护理干预3个月后,干预组服药依从性得分3-4分者占76.25%,与对照组(41.25%)相比,差异显著(P0.001),干预组的依从性明显高于对照组。结论加强老年高血压患者的自我管理可提高农村地区老年高血压患者的服药依从性,应加强对农村老年高血压患者的自我管理。     

Assessment of Oxidative DNA Damage by Alkaline Comet Assay in Human Essential Hypertension

The objective of the present study was to investigate the antioxidant status and the extent of oxidative DNA damage in lymphocytes and their relation with essential hypertension (EHT). A total of 100 South Indian subjects aged 30–65 were included for the study. Of these 50 were normotensive controls (group-1) with blood pressure ≥120/80 mm Hg, 50 were newly diagnosed (group-2) and were not on any antihypertensive drugs, but had systolic blood pressure ranging between 140 and 160 mmHg and diastolic blood pressure 95–100 mmHg and 50 newly diagnosed essential hypertensive patients underwent drug therapy for 1 year was considered as group-3. Enzymatic and non-enzymatic antioxidants significantly decreased and lymphocyte DNA damage was significantly increased in newly diagnosed hypertensive patients compared with control group. The major decrease in DNA damage and significant improvement in enzymatic and non-enzymatic antioxidants were observed after 1 year of antihypertensive therapy in treated group compared with newly diagnosed hypertensive patients. Total antioxidant status and lymphocyte DNA damage showed a strong negative correlation in all the three groups. Essential hypertension associated with oxidative stress which in turn causes genotoxic susceptibility to variety of disease including cancer. In the absence of DNA repair process and DNA checkpoint mechanisms, the genomic integrity is susceptible to extensive damage. In our study, increased oxidative DNA damage and decreased antioxidant levels were frequently observed in the newly diagnosed essential hypertensive patients, suggesting that oxidative stress is important in the pathogenesis of EHT. Therefore, the present study has additional clinical implication. Further investigations with large number of patients along with antioxidant supplement are highly warranted.     

hs-CRP: A potential marker for hypertension in Kashmiri population

Hypertension is the most important public health problem in developing countries and one of the major risk factors for cardiovascular diseases, and it has been reported that hypertension is in part an inflammatory disorder and several workers have reported elevated levels of CRP in hypertensive individuals. The main aim of the present study was to evaluate the association between blood pressure and serum CRP levels across the range of blood pressure categories including prehypertension. A total of 104 patients and 63 control subjects were included in the present study. The level of CRP in the serum samples was estimated by a high sensitivity immunoturbidometric assay. Standard unpaired student’s ‘t’ test was used for comparison of hs-CRP levels between hypertensive patients and normotensive control subjects and between patient groups with different grades of hypertension and different durations of hypertensive histories. The mean serum hs-CRP level in hypertensive patients was 3.26 mg/L compared with 1.36 mg/L among normotensive control subjects (P<0.001). On comparison with normotensive control subjects, the hs-CRP levels vary significantly both with grades and duration of hypertension, with most significant difference found in patients with prehypertension (P<0.001), followed by Stage-I (P=0.01) and Stage-II(P=0.02) hypertensives. Significant difference in hs-CRP levels was also found in patients with shorter duration of hypertensive history (≤ 1year) when compared with those with ≥5 years of hypertensive history (P<0.01). Our study reveals a graded association between blood pressure and CRP elevation in people with hypertension. Individuals with prehypertension or with shorter duration of hypertension (≤1 Year) had significantly a greater likelihood of CRP elevation in comparison to chronic stage-I or stage-II hypertensives.     

Urinary 8-OHdG: A marker of oxidative stress to DNA and total antioxidant status in essential hypertension with South Indian population

Establishment of non-invasive urinary biomarker for the early prediction of essential hypertension (EH) is important. We evaluated whether estimation of urinary DNA, serves as a marker to predict the extent of cellular oxidative stress in essential hypertension. A total of 180 South Indian subjects aged 30–65 were recruited for the study. Of these hypertensive subjects investigated, 30 were newly diagnosed and were not on any antihypertensive drugs, but had systolic blood pressure 140–160 mmHg and diastolic blood pressure 95–100 mmHg and 75 hypertensive patients who already on drug therapy for one year and 75 were South Indian normotensive healthy controls with blood pressure ≤ 120/80 mmHg. The 8-OHdG level in urine was significantly increased in hypertensive patients (both newly diagnosed and who already on drug therapy) compared with control group. The significant increase in 8-OHdG was observed in newly diagnosed hypertensive patients compared with hypertensive patients who already on drug therapy. There was a significant decrease in serum TAS value in essential hypertensive group when compared to control group. The urinary 8-OHdG was independently correlated with serum TAS. Decreased TAS levels, which reflect to increased oxidative stress, may be the reason of increased urinary 8-OHdG in South Indian hypertensive patients. Our preliminary data suggest that the competitive ELISA for 8-OHdG appears to be a simple method for quantifying the extent of oxidative stress.     

Association of Elevated Serum Lipoprotein(a), Inflammation,Oxidative Stress and Chronic Kidney Disease with Hypertension in Non-diabetes Hypertensive Patients

Hypertension is the most common cardiovascular risk factor. Lipoprotein(a) [Lp(a)], inflammation, oxidative stress and chronic kidney disease (CKD) exacerbate the response to tissue injury and acts as markers of the vascular disease, especially in glomerulosclerosis. We compared the clinical characteristics of 138 non-diabetes hypertensive women (ndHT) patients with 417 non-diabetes normotensive subjects and tested the association of hypertension with Lp(a), inflammation, CKD and oxidative stress by using multiple logistic regression. BP, BMI, waist circumference, creatinine, Lp(a), inflammation and malondialdehyde levels were significantly higher and CKD state in the ndHT patients (p < 0.05). Multiple logistic regression showed hypertension associated with increased Lp(a), inflammation, ORs and 95 % CIs were 2.52 (1.33, 4.80), 2.75 (1.44, 5.27) after adjusting for their covariates. Elevated serum Lp(a) and inflammation levels concomitants with increased oxidative stress and CKD were the major risk factors associated with hypertension and implications for the increased risk of HT and vascular disease.     

C677T MTHFR Gene Polymorphism is Contributing Factor in Development of Renal Impairment in Young Hypertensive Patients

Homocysteine concentration affected by the activities of the enzymes methylene tetra-hyrdofolate reductase (MTHFR). Polymorphisms in MTHFR gene associated with an impairment of MTHFR activity. Hyperhomocysteinemia is a result of single nucleotide polymorphisms (SNPs) in MTHFR 677 C>T that can cause homocysteine levels in the blood to increase. The purpose of this study is to investigate the relationships between MTHFR C677T (rs1801133) gene polymorphism, changes in homocysteine concentrations and progress of renal impairment in young adult hypertensive patients. Two hundred young hypertensive patients (age 21–24 years) were involved in this study; they were classified into patients with and without renal impairment in addition to 200 age and sex matched healthy controls. All participants were submitted to laboratory investigations as assay of MTHFR gene polymorphism C677T (rs1801133) by PCR/RFLP, determination of lipid profile, homocysteine and folic acid concentrations in addition to urinary albumin creatinine ratio (UACR). The levels of both homocysteine and UACR in the TT genotype patients were higher than those in the CC genotype group. Individuals who carry the T allele were more risky to hypertension and progress to early renal impairment in young age compared with those carrying the C allele [OR 2.02 (1.33–3.08), P < 0.001]. Genetic variants of C677T MTHFR gene and hyperhomocysteinemia may be responsible for rapid progress of renal impairment in Egyptian young age hypertensive patients. TT genotype or T allele may be considered as a predisposing factor for both elevated Hcy levels and the development of renal impairment. This study believed that lowering of homocysteine level can reduce renal impairment of hypertensive patients.     

体会老年患者创伤急救及护理的特殊性

临床实习护生在单纯理论学习中大多没有专门针对老年患者创伤急救进行专门培训,事实上老年创伤患者本身身体各种生理机能下降,并伴有不同程度的慢性疾病,在进行创伤急救的过程中与普通创伤病人的诊治护理方法明显不同。急救中心每日承担大量的内外妇儿疾病的急救工作,不同年龄、性别,不同科室的病人有时会同时送入,有效准确的分诊和应急处理对每一个接管护士都是一个考验。既要准确,又要合理地观察护理,某种意义上是对急救医生救治工作最有效的支持。护生的临床实习常规概念是课本理论知识的巩固与加强,但事实上许多是实践充实理论。急救中心工作有非常大的特殊性,除了过硬的护理操作实践技术外,不仅仅需要医护人员反应敏捷、配合娴熟,而且还要丰富的接诊治疗不同年龄、不同疾病病人经验,这些经验积累是学校护理理论学习中难以体会到的。急诊科一个月的实习,自身经验及临床知识的提升收获极大。     

Angiotensin Converting Enzyme Gene Polymorphism and its Association with Hypertension in South Indian Population

Hypertension, a well known risk factor for various cardiovascular, peripheral vascular and renal events is an important public health challenge. Renin angiotensin system (RAS) being the most vital pathogenic mechanism of hypertension is mediated by a key component; the angiotensin converting enzyme (ACE). The present study was aimed to know the relationship of ACE gene polymorphism and the possible risk of development of hypertension in south Indian population. The study included 101 clinically diagnosed hypertensive patients without any associated disease condition and 81 age and sex matched apparently healthy controls. Genotyping was performed using a polymerase chain reaction, (PCR) amplification of the intron 16 fragment harboring the 287 bp Alu repeat sequence. Three possible genotypes D/D, I/I homozygous and I/D heterozygous were analyzed where the D/D genotypes corresponds to higher ACE levels (D-Deletion, I-Insertion). The PCR products were separated on 2 % agarose gel. Statistical analysis was performed using SPSS.15 software program. We found a significance in frequency of D/D genotype in the hypertensive patients compared to the control group (p = 0.0005, odd’s ratio = 4.157). This suggested that ACE (D/D) genotypes are more prone for the development of hypertension. This is relatively a pilot study; but nevertheless may assist in identifying the pathophysiological cause of hypertension.     

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Conditions like hypertension, atherosclerosis and diabetes are known to be the result of endothelial dysfunction which could begin early in the life of an individual. The markers of endothelial dysfunction studied in the present work are plasma hemoglobin, serum high sensitivity C-reactive protein (hsCRP) and plasma nitrite and nitrate. We studied the onset of endothelial dysfunction with increase in age as well as in disease condition like newly detected hypertensives and of hypertensive diabetic patients. The mean plasma hemoglobin and hsCRP values were found to increase with age. hsCRP and plasma hemoglobin levels were significantly higher in patient groups as compared to aged-matched controls. On the other hand nitrate and nitrite was significantly higher in patients who suffered from both diabetes and hypertension together and nitrate values were significantly lower in patients who suffered from hypertensive alone. Plasma hemoglobin and hsCRP are associated with endothelial dysfunction and increases both with age as well as in disease condition.     

信息生态视角下老年人医养结合信息服务需求探索

[目的/意义]探索老年人的医养结合信息服务需求,对丰富老年群体信息服务研究、建设智慧化医养结合服务体系、推进我国养老产业发展具有重要意义.[方法/过程]以信息、信息主体和信息环境为生态因子构建老年人医养结合信息服务需求指标,综合运用KANO模型和k-means方法划分指标类别和重要度等级.[结果/结论]医疗类信息服务、...