膀胱灌注量对重症患者经膀胱腹内压测量的影响  

The impact of bladder infusion volumes on transvesical intra-abdominal pressure measurement of critically ill patients

作　　者：张淑香[1] 王淑玲[1] 曹允芳[1] 解建[1] 李涛[1] 张明[1] 孙楠楠[1] 宋洁[2] 

机构地区：[1]济南市山东省千佛山医院ICU,250014 [2]山东中医药大学

出　　处：《中华护理杂志》2012年第9期806-807,共2页Chinese Journal of Nursing

基　　金：山东省医药卫生科技发展计划项目(编号:2009HW072)

摘　　要：目的探讨重症患者膀胱灌注量对经膀胱腹内压测量的影响,寻求能反映腹内压的最佳膀胱灌注量,以指导腹腔室隔综合征的早期诊断和治疗。方法 55例有大量腹水并放置腹腔引流管的ICU患者,分别取膀胱灌注量为0、10、20、30、50ml时经膀胱腹内压,即经尿管测定的膀胱压,与用腹腔引流管直接测量的腹内压进行比较。结果膀胱灌注量为10ml时所测得的膀胱压与直接测量的腹内压比较,差异无统计学意义(t=0.216,P=0.83),相关系数r为0.953。其他灌注量下所测得的膀胱压与腹内压比较,差异均有统计学意义(P<0.001)。结论当膀胱灌注量为10ml时,膀胱压能准确反映腹内压,膀胱压与腹内压呈明显的正相关关系。Objective To examine the impact of bladder infusion volumes on the measurement of transvesieal intraabdominal pressure,i.e, intravesical pressure（IVP） and intra-abdominal pressure（IAP） among critically ill patients and to determine the best infusion volumes to provide reliable evidence for the early diagnosing and treatment of abdominal compartment syndrome（ACS）. Methods Fifty-five critically ill patients with ascites were recruited in the study. The IVP measured through urinary catheter and the IAP measured through intra-abdominal drainage tube were compared when the bladder infusion volumes was 0ml, 10ml,20ml,30ml,50ml,respectively. Results There was no significant difference between the IVP and IAP when the bladder infusion volume was 10ml（t=0.216,P=0.83）. The correlation coefficient was 0.953. The IVP was significantly different from the IAP when the bladder infusion volume was 20ml,30ml and 50ml（P〈0.01）. Conclusion There is close correlation between IVP and IAP. The IAP can be accurately estimated by measurement of IVP when the bladder infusion volume is 10ml.

关 键 词：膀胱灌注量 膀胱压 腹内压 腹腔室隔综合征 

分 类 号：R472[医药卫生—护理学]