腹内压检测在危重症患者诊断与治疗中的价值  

The value of intra-abdominal pressure test in diagnosis and treatment of serious illness patients

作　　者：周伟梁[1] 秦伟毅[1] 苏磊[1] 华黎电[1] 彭雄[1] 

机构地区：[1]广州军区广州总医院急诊科,广东广州510010

出　　处：《现代预防医学》2012年第6期1582-1583,1585,共3页Modern Preventive Medicine

摘　　要：目的探讨腹内压(IAP)检测在临床危重病患者诊断和治疗中的作用。方法用膀胱测压法对256例患者检测腹内压,分别记录每例患者入院时和入院后d1、d2、d3IAP值,对数据进行汇总与分析。结果 256例患者中,内科腹内压﹤10mmHg者12例、10～14mmHg17例、15～24mmHg14例、25～34mmHg11例、≥35mmHg15例;外科腹内压﹤10mmHg者42例、10～14mmHg21例、15～24mmHg67例、25～34mmHg39例、≥35mmHg18例;内、外科患者IAP平均值分别为(15.8±4.2)mmHg和(17.3±5.7)mmHg,其差异有统计学意义(t=1.9867,P﹤0.05);对33例腹内压≥35mmHg的17患者行手术减压治疗,死亡5例,非手术治疗的16例患者均死亡,差异有统计学意义(χ2=14.83,P=0.0001);死亡组患者31例,腹内压平均值为(31.7±3.9)mmHg,存活组患者225例,腹内压平均值为(14.8±3.2)mmHg,其差异有统计学意义(t=26.8092,P=0.001)。结论腹内压高低与患者病情及预后有密切关系,对重症患者入院后进行腹内压测定有助于病情的评估和预后判断。OBJECTIVE To explore the value of intra-abdominal pertension （IAH） detect in diagnosis and therapy of Serious illness patients. METHODS The intra-abdominal？pressure of 256 cases were detected with test pressure of the bladder, and recored the IAP at the time of 1, 2 and 3 days before and after being hospitalized. RESULTS Among 256 cases patients, 12 cases showed medical INH 〈 10mm Hg, 17 cases showed 10-14mm Hg, 14 cases showed 15-24mm Hg, 11 cases showed 25-34mm Hg, 15 cases showed ≥35mm Hg, 42 cases showed surgical INH 〈 10mm Hg, 21 cases showed 10-14mm Hg, 67 cases showed 15-24mm Hg, 39 cases showed 25-34mm Hg and 18 cases showed ≥35mm Hg; The medical and surgical cases of the INH average values were （15.8± 4.2） mm Hg and （17.3 ± 5.7） mm Hg, and there was significant difference （t = 1.986 7, P〈 0.05）. Among 33 cases showed INH ≥35mm Hg, 17 cases were taken surgery for pressure-relief treatment, and 5 cases died. 16 cases without operation pressure-relief died, there was significant difference （X^2 = 14.83, P = 0.0001） ; 31 died cases showed the average INH value was （31.7±3.9） mm Hg, and 225 cases patients survived and with the average INH of （31.7±3.9） mm Hg. There was significant difference between groups （t = 26.8092, P = 0.001）. CONCLUSON Higher or lower intra-abdominal？pressure had closely association with illness status and its prognosis serious, and the intra-abdominal？ pressure is helpful for disease assessment and prognosis.

关 键 词：腹内压 检测 危重病患者 诊断与治疗 

分 类 号：R572[医药卫生—消化系统]