Yüksel Serpil, Altun-Uğraş Gülay, Altınok Nurhan, Demir Necla
Department of Surgical Nursing, Division of Nursing, Necmettin Erbakan University Faculty of Nursing, Konya, Turkey.
Department of Surgical Nursing, Mersin University Faculty of Nursing, Mersin, Turkey.
Florence Nightingale J Nurs. 2020 Jul 3;28(2):205-212. doi: 10.5152/FNJN.2020.19119. eCollection 2020 Jun.
This study aimed to determine the effect of a cuff properly sized for mid-upper arm circumference on blood pressure measurement in obese surgical patients.
This prospective crossover clinical trial was conducted with 100 patients who had body mass index ≥30 kg/m and mid-upper arm circumference ≥27 cm and were admitted to the general surgery unit of a medical faculty hospital in İstanbul, Turkey between January 1, 2015, and December 31, 2015. Blood pressure of the patients was measured using a small-sized adult cuff and a cuff properly sized for mid-upper arm circumference.
Among the patients, 39% were morbidly obese and 67% had mid-upper arm circumference between 35 and 44 cm. Systolic blood pressure of the patients with a small adult cuff was 20.78 mmHg higher than that obtained with a cuff properly sized for mid-upper arm circumference, and their diastolic blood pressure was 10.15 mmHg higher on average (p<0.001). Only 6% of those with systolic hypertension according to the small adult cuff readings were found to have hypertension according to the cuff properly sized for mid-upper arm circumference (p<0.001).
The results showed that, in obese surgical patients, blood pressure is measured inaccurately and found to be falsely high when measurements are not performed using a cuff properly sized for mid-upper arm circumference.
本研究旨在确定尺寸适合上臂中段周长的袖带对肥胖外科患者血压测量的影响。
本前瞻性交叉临床试验纳入了100例体重指数≥30kg/m²且上臂中段周长≥27cm的患者，这些患者于2015年1月1日至2015年12月31日期间入住土耳其伊斯坦布尔一家医学院附属医院的普通外科。使用小号成人袖带和尺寸适合上臂中段周长的袖带测量患者的血压。
患者中，39%为病态肥胖，67%的上臂中段周长在35至44cm之间。使用小号成人袖带测量的患者收缩压比使用尺寸适合上臂中段周长的袖带测量的收缩压高20.78mmHg，其舒张压平均高10.15mmHg（p<0.001）。根据小号成人袖带读数诊断为收缩期高血压的患者中，仅6%根据尺寸适合上臂中段周长的袖带测量被诊断为高血压（p<0.001）。
结果表明，在肥胖外科患者中，若不使用尺寸适合上臂中段周长的袖带进行测量，血压测量不准确且会被误测为偏高。
