WONCA研究论文摘要汇编——医生记录的血压比护士的要高:系统评价及荟萃分析

发布时间：2018-01-11 23:08

  本文关键词：WONCA研究论文摘要汇编——医生记录的血压比护士的要高:系统评价及荟萃分析　出处：《中国全科医学》2014年23期 　论文类型：期刊论文

  更多相关文章： WONCA 白大衣效应 加权均数差 荟萃分析 医学标准 会议摘要 评价员 随机效应 汇总数据 测量结果

【摘要】：背景致血压升高的"白大衣效应",医生要大于护士。这也许能够左右对护士主导高血压管理及医生临床上过高评估或过度治疗高血压方面研究的解释。目的量化医生和护士血压测量结果的差异。研究设计与场所系统评价及荟萃分析Medline,Central,CINAHL,EMBase数据库、杂志、会议摘要等的检索结果。方法由2位评价员选择报道医生测量成人平均血压及同期护士测量成人平均血压的研究并提取平均血压,使用改良循证医学标准评估测量血压偏好风险,用随机效应荟萃分析对结果进行汇总。结果 1 899篇文献中含15项研究(11项为高血压,4项为伴发高血压和血压正常)。与医生测量结果相比,护士测量的血压要低〔收缩压加权均数差=-7.0 mm Hg(1 mm Hg=0.133 kPa),95%CI(-4.7,-9.2);舒张压加权均数差=-3.8 mm Hg,95%CI(-2.2,-5.4)〕;偏好风险低的研究差异要小〔收缩压加权均数差=-4.6 mm Hg,95%CI=(-1.9,-7.3);舒张压加权均数差=-1.7 mm Hg,95%CI=(-0.1,-3.2)〕。基于医生读数的"白大衣高血压"诊断的频率比护士明显要高〔OR=1.6,95%CI(1.2,2.1)〕。结论就血压测量而言,护士的"白大衣效应"比医生要小。这种系统性的差异对高血压诊断及处置具有启示意义。注意:在汇总数据时要求同时使用护士及医生测量的血压。
[Abstract]:Background the "white coat effect" of blood pressure rise. Doctors are larger than nurses. This may influence the interpretation of nurse-led hypertension management and clinical overassessment or overtreatment of hypertension by doctors. Objective to quantify differences in blood pressure measurements between doctors and nurses. Research design and site system evaluation and meta-analysis Medline. Central / CINAHLU EMBase database, magazine. Methods the average blood pressure of adult was measured by two evaluators and the average blood pressure of adults was measured by nurses in the same period and the average blood pressure was extracted. The risk of blood pressure preference was evaluated by modified evidence-based medicine standard, and the results were summarized by random effect meta-analysis. Results there were 15 studies and 11 items of hypertension in 1 899 articles. Four items were associated with high blood pressure and normal blood pressure. The blood pressure measured by nurses should be low (systolic blood pressure weighted mean difference: -7.0 mm Hg(1 mm Hg=0.133 KPA 95 CI = -4.7 ~ (-9.2)); The weighted mean difference of diastolic blood pressure was 3.8mm HgC95C ~ (-2.2) ~ (-5.4) m ~ (-1); The difference of preference risk was small (systolic pressure weighted mean difference was -4.6 mm HgGN 95) and CIQ was -1.9 ~ (-7.3) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (-7) ~ (3); The weighted mean difference of diastolic blood pressure (DBP) was -1.7 mm Hg ~ (95) CI ~ (-0.1). The frequency of diagnosis of "white coat hypertension" based on doctor's reading was significantly higher than that of nurses. Conclusion in terms of blood pressure measurement, the frequency of diagnosis was significantly higher than that of nurses. The "white coat effect" of nurses is smaller than that of doctors. This systematic difference is instructive for the diagnosis and management of hypertension.
【作者单位】： 中国石油天然气集团公司中心医院;
【分类号】：R544.1
【正文快照】： WONCA研究论文摘要汇编——医生记录的血压比护士的要高:系统评价及荟萃分析@周淑新$中国石油天然气集团公司中心医院 @Clark CE @Horvath IA @Taylor RS背景致血压升高的"白大衣效应",医生要大于护士。这也许能够左右对护士主导高血压管理及医生临床上过高评估或过度治疗，

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