2024兒童血壓測(cè)量規(guī)范

兒童血壓測(cè)量規(guī)范2024版目次前言 II范圍 1規(guī)范性引用文件 1術(shù)語(yǔ)和定義 1基本要求 1儀器要求 2診室血壓測(cè)量 2動(dòng)態(tài)血壓測(cè)量 2附錄A（資料性）3~17歲男童年齡別及身高別血壓 3附錄B（資料性）3~17歲女童年齡別及身高別血壓 7附錄C（資料性）兒童血壓分類 11附錄D（規(guī)范性）兒童診室血壓測(cè)量操作流程 12附錄E（規(guī)范性）兒童動(dòng)態(tài)血壓測(cè)量操作流程 13I兒童血壓測(cè)量規(guī)范范圍本文件規(guī)定了3~17歲兒童血壓測(cè)量的基本要求、儀器要求、診室血壓測(cè)量和動(dòng)態(tài)血壓測(cè)量。本文件適用于各級(jí)各類醫(yī)療機(jī)構(gòu)從事兒童血壓測(cè)量的注冊(cè)護(hù)士。規(guī)范性引用文件（包括所有的修改單適用于本文件。WS/T424人群健康監(jiān)測(cè)人體測(cè)量方法術(shù)語(yǔ)和定義下列術(shù)語(yǔ)和定義適用于本文件。3.1血壓bloodpressure血液在血管中流動(dòng)，流動(dòng)的血液對(duì)單位面積血管壁的作用力，即流動(dòng)血液的側(cè)壓。一般以毫米汞柱為動(dòng)脈壓的單位，國(guó)際單位為千帕（1mmHg=0.133kPa）。注：在實(shí)際臨床和研究中，常將動(dòng)脈壓簡(jiǎn)稱為“血壓”，本標(biāo)準(zhǔn)血壓亦指動(dòng)脈壓。[來(lái)源：WS/T610-2018，3.1，有修改]3.2血壓測(cè)量bloodpressuremeasurement評(píng)估血壓水平、診斷高血壓以及觀察降壓療效的主要方法，分為診室血壓測(cè)量、動(dòng)態(tài)血壓測(cè)量和家庭血壓測(cè)量三種類型。3.3診室血壓測(cè)量officebloodpressuremeasurement醫(yī)護(hù)人員在標(biāo)準(zhǔn)條件下，使用符合標(biāo)準(zhǔn)的測(cè)量?jī)x器按照統(tǒng)一規(guī)范進(jìn)行血壓測(cè)量（3.2）的方式。3.4動(dòng)態(tài)血壓測(cè)量ambulatorybloodpressuremeasurement使用符合標(biāo)準(zhǔn)的動(dòng)態(tài)血壓測(cè)量?jī)x器，在常規(guī)活動(dòng)期間多次完成血壓測(cè)量（3.2）的方式?；疽?~12個(gè)月進(jìn)行復(fù)訓(xùn)。見(jiàn)附錄AB和附錄C。WS/T424的要求測(cè)量?jī)和纳砀吆腕w重。1儀器要求應(yīng)選擇在兒童中經(jīng)過(guò)國(guó)際標(biāo)準(zhǔn)驗(yàn)證的上臂袖帶式電子血壓測(cè)量?jī)x器。/6個(gè)月對(duì)血壓測(cè)量?jī)x器進(jìn)行校準(zhǔn)。應(yīng)根據(jù)上臂圍大小選擇合適的袖帶型號(hào)。診室血壓測(cè)量31次。3D進(jìn)行兒童診室血壓測(cè)量。動(dòng)態(tài)血壓測(cè)量宜對(duì)年齡≥5歲或身高≥120cm且存在以下情況之一的兒童進(jìn)行動(dòng)態(tài)血壓測(cè)量：——診室血壓測(cè)量結(jié)果異常；——存在高血壓危險(xiǎn)因素；——接受降壓治療。E進(jìn)行兒童動(dòng)態(tài)血壓測(cè)量。應(yīng)設(shè)置監(jiān)測(cè)時(shí)長(zhǎng)≥24h170%以上，即日207個(gè)有效讀數(shù)。若不能滿足，應(yīng)重復(fù)測(cè)量。宜使用動(dòng)態(tài)血壓監(jiān)測(cè)日記卡確定日間和夜間的時(shí)間段，也可使用預(yù)定義的閾值。24h應(yīng)對(duì)佩戴動(dòng)態(tài)血壓測(cè)量?jī)x器的兒童及家屬進(jìn)行相關(guān)知識(shí)的教育：——應(yīng)避免競(jìng)技運(yùn)動(dòng)或其他劇烈身體活動(dòng)；——袖帶充氣時(shí)應(yīng)保持測(cè)量手臂不動(dòng)，直至放氣完成；——若袖帶過(guò)緊導(dǎo)致不適或過(guò)松導(dǎo)致移位，可根據(jù)標(biāo)記的肱動(dòng)脈位置重新調(diào)整；——應(yīng)避免連接導(dǎo)管打折、扭轉(zhuǎn)或堵塞，避免袖帶受壓；——測(cè)量間歇期可取下儀器進(jìn)行更衣和洗澡，但不可弄濕及關(guān)閉儀器；——睡眠時(shí)可將設(shè)備放置床上或枕頭下；——若出現(xiàn)故障，如袖帶反復(fù)充氣時(shí)，應(yīng)按下開(kāi)始/停止按鈕，袖帶將會(huì)放氣且不會(huì)讀取本次讀數(shù)；——填寫(xiě)動(dòng)態(tài)血壓監(jiān)測(cè)日記卡，記錄時(shí)間、活動(dòng)、癥狀、用藥情況和測(cè)量結(jié)果。2附錄 A資料性）3~17歲男童年齡別及身高別血壓年齡（歲）身高百分位值身高（cm）收縮壓（mmHg）舒張壓（mmHg）P50P90P95P99P50P90P95P993P5＜96889910210854626572P1096~978810010310954636572P2598~1008910110411054636672P50101~1039010210511254636673P75104~1069110310711355636673P90107~1089210410711455636673P95≥10993105108115556366734P5＜1028910110411155646774P10102~1049010210511155646774P25105~1079110310611355646774P50108~1109210410811456646774P75111~1139310610911556646774P90114~1169410711011756656875P95≥11795107111117566568755P5＜1099210410711456656875P10109~1109210410711456656875P25111~1139310510911556656875P50114~1179410611011757656976P75118~1209510811111857666976P90121~1239610911211958677077P95≥12497110113120586770776P5＜1149310510911557666976P10114~11694106110116576669763P25117~1199510711111758666977P50120~1239610811211958677078P75124~1269711011312059687178P90127~1299811111512159697279P95≥13099112116123606973807P5＜1189410611011758677077P10118~1209510711111858677078P25121~1239610811211959687178P50124~1279711011312059687279P75128~1319811211512260707381P90132~13510011311712461717482P95≥136100114117125627174828P5＜1219510811111859687178P10121~1239510811211959687179P25124~1279711011312060697280P50128~1329811111512261707381P75133~1369911311712462717482P90137~13910111411812562727583P95≥140102115119127637376849P5＜1259610911211960697280P10125~1289610911312060697380P25129~1329811111512261717482P50133~1379911311712462727583P75138~14210111511912663737684P90143~14510211612012864737785P95≥1461031171211296474778510P5＜1309711011412161707481P10130~13298111115122627174824P25133~1379911311612462727583P50138~14210111511912663737785P75143~14710211712012864747785P90148~15110411812213064747786P95≥1521051191231316474778611P5＜1349811111512262727583P10134~1379911211612463727684P25138~14210011411812664737785P50143~14810211612012864747886P75149~15310411912313064747886P90154~15710612012413264747886P95≥1581061211251336474788612P5＜14010011311712564737785P10140~14410111511912664747886P25145~14910211712112865757886P50150~15510411912313165757886P75156~16010612112513365757886P90161~16410812312713565757887P95≥1651081241281366575788713P5＜14710211612012865757886P10147~15110311712112965757887P25152~15610411912313165757987P50157~16210612112513365757987P75163~16710812312813665757987P90168~17111012513013866767987P95≥1721101261301396676798814P5＜15410311812213065757987P10154~157104119124132657579875P25158~16210612112513365757987P50163~16710812312813665757987P75168~17210912513013866767988P90173~17611112713114066768088P95≥1771121281331416777808915P5＜15810512012413265767987P10158~16110612112513365767987P25162~16610712212713566767988P50167~17010912412813766768088P75171~17411012613113966778089P90175~17811212813214167778189P95≥1791131291331426777819016P5＜16110512112513366767988P10161~16410612112613466767988P25165~16810712312713666768088P50169~17210912512913866768088P75173~17611112613114067778089P90177~17911212813314167778190P95≥1801131291341426778819017P5＜16310612112613466768088P10163~16510712212613566768088P25166~16910812412813666768088P50170~17310912513013867778089P75174~17711112713114067778189P90178~18011212913314267788190P95≥18111312913414368788290注：1.年齡以1歲為單位，根據(jù)四舍五入的原則采用整數(shù)。2.測(cè)量的身高若包含小數(shù)，應(yīng)四舍五入取整數(shù)后再查對(duì)此表。6附錄 B（資料性）3~17歲女童年齡別及身高別血壓年齡（歲）身高百分位值身高（cm）收縮壓（mmHg）舒張壓（mmHg）P50P75P95P99P50P75P95P993P5＜95879910210855636774P1095~96889910310955636774P2597~998810010311055646774P50100~1028910110411155646774P75103~1059010210511255646774P90106~1079110310611355646775P95≥10891103107113566467754P5＜1018910110511156646775P10101~1038910110511156646775P25104~1069010210611256646775P50107~1099110310711356646775P75110~1129210410711456656875P90113~1149310510911556656876P95≥11593105109115566568765P5＜1089110310611356656876P10108~1099110310711356656876P25110~1129210410711456656876P50113~1169310510911557656876P75117~1199310610911657666977P90120~1229410711111758667077P95≥12395108111118586770786P5＜1139210410811557656976P10113~11492105108115576669777P25115~1189310610911657666977P50119~1219410711011758677078P75122~1259510811211858677179P90126~1289610911311959687179P95≥12997110114121596972807P5＜1169310510911557666977P10116~1189310610911657666977P25119~1229410711011758677078P50123~1269510811211959687179P75127~1309610911312059697280P90131~1339711111412260697381P95≥13498112115122617073828P5＜1209410611011658677078P10120~1229410711111758677179P25123~1269510811211959687179P50127~1319610911312060697280P75132~1359811111512261707382P90136~1389911211612361717483P95≥139100113117124627175839P5＜1249510811111859687179P10124~1279510811211959687280P25128~1329711011312060697381P50133~1369811111512261717482P75137~14110011311712462727584P90142~14510111411812563727684P95≥1461021151191266373768510P5＜1309610911312060697381P10130~13397110114121617073828P25134~1389911211612362717583P50139~14310011311712463727684P75144~14710111511912663737685P90148~15110311612012863737785P95≥1521031171211296473778611P5＜1369811211512262717583P10136~1399911311612362727584P25140~14410111411812563737685P50145~14910211612012764737786P75150~15410311712112864747786P90155~15710411812212964747786P95≥1581041181221306474778612P5＜14210011311712463737685P10142~14510111411812563737785P25146~15010211612012764747786P50151~15410311712112964747886P75155~15810411812213064747887P90159~16210511912313064747887P95≥1631051191231316474788713P5＜14710111511912664747786P10147~14910211612012764747887P25150~15310311712112864747887P50154~15710411812212965747887P75158~16110511912313065747887P90162~16410511912313165747887P95≥1651051191231316575788714P5＜14910211612012765747887P10149~152103117121128657578879P25153~15510411812212965757887P50156~15910411812213065757887P75160~16310511912313065757887P90164~16610511912313165757987P95≥1671061201241316575798815P5＜15110311612012865757987P10151~15210311712112865757988P25153~15610411812212965757988P50157~16010511912313065757988P75161~16310511912313165757988P90164~16610512012413165757988P95≥1671061201241316575798816P5＜15110311712112865757988P10151~15310311712112965757988P25154~15710411812213065757988P50158~16010511912313065757988P75161~16410511912313166767988P90165~16710612012413166767988P95≥1681061201241326676798817P5＜15210311712112966767988P10152~15410411812212966767989P25155~15710411812213066768089P50158~16110511912313066768089P75162~16410511912413166768089P90165~16710612012413266768089P95≥16810612012413266768089注：1.年齡以1歲為單位，根據(jù)四舍五入的原則采用整數(shù)。2.測(cè)量的身高若包含小數(shù)，應(yīng)四舍五入取整數(shù)后再查對(duì)此表。10附錄 C（資料性）兒童血壓分類分類內(nèi)容正常血壓收縮壓和（或）舒張壓＜同性別、同年齡別和同身高別血壓的P90正常高值血壓（或舒張壓≥P90或≥120/80mmHg，且＜同性別、同年齡別和同身高別血壓的P95）血壓偏高收縮壓和（或）舒張壓≥同性別、同年齡、同身高百分位人群血壓的P95高血壓非同