持续性血液净化治疗对腹腔内高压患者的胃肠功能障碍的影响  

作　　者：张磊[1] 吕光宇[1] 黄典[1] 张奇[1] 

机构地区：[1]柳州市人民医院重症医学科,广西壮族自治区545000

出　　处：《中华临床医师杂志（电子版）》2016年第4期212-213,共2页Chinese Journal of Clinicians(Electronic Edition)

基　　金：“广西壮族自治区卫生厅自筹经费科研课题：腹腔间隔室综合征腹压监测与临床干预研究”,课题编号：Z2012582.

摘　　要：目的 探究持续性血液净化技术对腹腔内高压患者胃肠功能障碍的治疗效果.方法 将50例胃肠功能障碍的腹内高压患者随机分为治疗组和对照组,各25例.对照组采用常规方法治疗,治疗组则选择持续性血液净化技术治疗.统计患者一般信息、患者体征和腹内压指标.结果 治疗组和对照组在年龄、性别、体质指数、机械通气情况、包含乳酸、ph、血肌酐、血红蛋白含量、白细胞、血小板数目在内的血液各项指标、住院时间均无统计学差异（P〉0.05）.但ICU入住时间治疗组明显短于对照组,具有统计学差异,P〈0.05.治疗前后MAP变化不明显（P〉0.05）,但IAP、APP和SOFA评分都有明显差异,P〈0.05,治疗组的APP明显增高,IAP和SOFA评分显著降低.结论 CBP 可以在早期改善IAH患者的脏器功能,降低腹腔内压,提高灌注,对胃肠道有着积极有效的保护作用,为进一步诊治提供条件.Objective To explore the continuous blood purification technology of gastrointestinal dysfunction in patients with intra-abdominalpressure treatment effect. Methods 50 patients with gastrointestinal dysfunction of internal high pressure were randomly divided into treatment group andcontrol group, 25 cases each. Control group were treated with conventional methods, while the treatment group chose continuous blood purificationtreatment technology. General information, patients signs and intra-abdominal pressure indicators were recorded. Results The results between treatmentgroup and control group in age, sex, body mass index, mechanical ventilation conditions, including lactic acid, ph, serum creatinine, hemoglobin content,number of white blood cells, platelets, all the indexes of blood, length of hospital stay were no statistical difference （P 〉 0.05）. But the ICU stay timesignificantly of the treatment group was shorter than the control group with statistical difference, P 〈 0.05. The MAP before and after does not changesignificantly （P 〉 0.05）, but the IAP, APP and SOFA scores had significant difference, P 〈 0.05. The APP of treatment group was obviously higher, and IAP,SOFA score significantly reduced. Conclusion CBP can improve the IAH viscera function of patients in the early days, reduce intra-abdominal pressureand improve the infusion, which have a positive and effective protection for the gastrointestinal tract, provide the conditions for further diagnosis andtreatment.

关 键 词：持续性血液净化 腹腔内高压 胃肠功能障碍 

分 类 号：R725.7[医药卫生—儿科]