Journal of Hayat
حیات
Hayat
Medical Sciences
http://hayat.tums.ac.ir
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1735-2215
2008-188X
fa
jalali
1403
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gregorian
2024
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مقایسه تأثیر جوراب الاستیک و بالا بردن اندام تحتانی بیماران بر پیشگیری از کاهش فشارخون ناشی از انجام پلاسمافرز
The effect of elastic stockings and leg elevation on the prevention of hypotension during plasmapheresis
مراقبتهاي پرستاري
Nursing Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">زمینه و هدف: </span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">افت فشارخون از عوارض شایع پلاسمافرزیس است. بالابردن پاها و استفاده از جوراب الاستیک از جمله اقدامات پرستاری در پیشگیری از کاهش فشارخون است. هدف از این مطالعه، مقایسه تأثیر جوراب الاستیک و بالا بردن اندام تحتانی بر پیشگیری از کاهش فشارخون ناشی از انجام پلاسمافرز بوده است</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">.</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.3pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">این مطالعه کارآزمایی بالینی متقاطع تصادفی در مورد 35 بیمار تحت پلاسمافرز در بیمارستان­ بهشتی شهر همدان در سال 1400-1399 انجام گرفت. بیماران به صورت در دسترس انتخاب و سپس با استفاده از بلوک­های جایگشتی تصادفی در طی 4 جلسه به چهار روش جوراب الاستیک (</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">A</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">)، بالا بردن اندام تحتانی (</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">B</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">)، جوراب الاستیک به همراه بالا بردن اندام تحتانی (</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">C</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">) و کنترل (</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">D</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">) تخصیص یافتند. در زمان­های قبل، حین (به فاصله هر نیم ساعت) و نیم ساعت پس از پایان پلاسمافرز، فشارخون کنترل شد. تجزیه و تحلیل داده­ها با استفاده از </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">SPSS</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> نسخه 24 </span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">و آزمون تحلیل واریانس با اندازه­گیری­های مکرر در سطح معناداری 05/0 انجام یافت<span style="letter-spacing:-.3pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:.1pt">یافتهها</span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:.1pt">: </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">در حین پلاسمافرز، در هر 4 روش­، فشارخون سیستولیک بیماران در طی زمان روند کاهشی داشت (001/0></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">p</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">). فشارخون بیماران در روش­های مداخله </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">A</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">، </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">B</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> و </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">C</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> بالاتر از روش کنترل بود (001/0></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">p</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">). در بین روش­های مداخله، فشارخون در روش </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">C</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> بالاتر از روش­های </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">A</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> و </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">B</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">، و روش </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">B</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> بالاتر از روش </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">A</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> بود (001/0></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">p</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">)<span style="letter-spacing:.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">نتیجهگیری: </span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">استفاده از جوراب الاستیک به همراه بالا بردن اندام تحتانی جهت جلوگیری از افت فشارخون مؤثرتر است. بنابراین، به عنوان روشی آسان و کم هزینه برای جلوگیری از افت فشارخون به بیماران تحت پلاسمافرز و پرستاران توصیه می­شود</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">.</span></span></span></i></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">ثبت کارآزمایی بالینی:</span></span></i></b><i> </i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">IRCT20191020045166N1</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">Background & Aim:</span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">Hypotension is a common complication associated with plasmapheresis. Elevating the legs and using elastic stockings are nursing interventions aimed at preventing hypotension. The objective of this study was to compare the effects of elastic stockings and leg elevation on the prevention of hypotension during plasmapheresis</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">Methods & Materials:</span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">This randomized crossover clinical trial was conducted on 35 patients undergoing plasmapheresis at Beheshti Hospital in Hamadan from 2020 to 2021. Patients were selected based on convenience sampling and then allocated to four different methods in four sessions using random permuted block designs: elastic stockings (A), leg elevation (B), a combination of elastic stockings and leg elevation (C), and a control group (D). Blood pressure was monitored before, during (every half hour), and half an hour after the completion of plasmapheresis. Data analysis was performed using SPSS version 24, applying repeated measures ANOVA with a significance level of 0.05</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="layout-grid-mode:line">Results:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">During plasmapheresis, systolic blood pressure decreased over time in all four methods (<i>P</i><0.001). Blood pressure measurements in intervention methods A, B, and C were higher than in the control group (<i>P</i><0.001). Among the intervention methods, blood pressure in method C was higher than in methods A and B, while method B was higher than method A (<i>P</i><0.001)</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">The use of elastic stockings in combination with leg elevation is more effective in preventing hypotension. Therefore, it is recommended as an easy and cost-effective method for preventing hypotension in patients undergoing plasmapheresis and for nursing staff to implement.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">Clinical trial registry:</span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">IRCT20191020045166N1</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span><br>
پلاسمافرزیس, افت فشارخون, جوراب ساق بلند, فشرده سازی, بیماران
plasmapheresis, hypotension, stockings, compression, patients
187
201
http://hayat.tums.ac.ir/browse.php?a_code=A-10-2554-2&slc_lang=fa&sid=1
Khodayar
Oshvandi
خدایار
عشوندی