连续性血液净化对腹内高压患者腹腔内压力及胃肠功能障碍的影响  

The influence of continuous blood purification on the intra -abdominal pressure and the gastrointestinal ;dysfunction of intra-abdominal hypertension

作　　者：白敬恩[1] 魏云彪[1] 李宏[1] 

机构地区：[1]吕梁市人民医院肾内科,山西省吕梁033000

出　　处：《中国基层医药》2017年第2期290-293,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨连续性血液净化（CBP）对腹腔内高压（IAH）患者腹腔内压力（IPA）及胃肠功能障碍的影响。方法选取IAH患者80例，采用数字表法随机分为观察组和对照组各40例。观察组给予CBP治疗3 d；对照组给予常规治疗。分别检测治疗前和治疗后平均动脉压（MAP）、IPA及腹腔灌注压（APP），观察并统计胃肠道症状数量，采用序贯器官衰竭评分（SOFA）评估器官功能。结果治疗前两组MAP、IAP、APP及SOFA评分差异均无统计学意义（均P＞0．05）；治疗后，两组的MAP[（88．46±8．93）mmHg比（87．76±8.04）mmHg]差异无统计学意义（P＞0．05）；观察组治疗后IAP[（9．02±1．06）mmHg]和SOFA评分[（1．32±0．45）分]较治疗前[（19．54±4．23）mmHg和（5．24±2．05）分]明显降低、APP[（85．34±7．59）mmHg]较治疗前[（70．76±6．43）mmHg]明显升高，明显优于对照组，差异均有统计学意义（t＝3．575、2．855、3．274、3．563、3．114、3．782，均P＜0．05）；治疗前，两组的胃肠道症状数[（44．56±8．53）次比（45．32±8．21）次]差异无统计学意义（均P＞0．05）；治疗后观察组胃肠道症状数[（6．54±2．24）次]较治疗前明显减少，且明显均低于对照组[（15．45±4．43）次]，差异有统计学意义（t＝3．022，P＜0．05）。观察组30 d、60 d生存率分别为87．5％（35／40）、65％（26／40），对照组分别为80．0％（32／40）、55％（22／40），观察组虽然高于对照组，但差异均无统计学意义（均P＞0．05）。结论 CBP能显著降低腹内高压患者的IPA，使APP升高，改善胃肠道灌注，减少胃肠道症状，对改善胃肠道功能障碍具有积极的意义。Objective To study the influence of continuous blood purification（CBP）on the intra-abdomi-nal pressure （IAP ） and the gastrointestinal dysfunction of intra -abdominal hypertension （IAH ）.Methods 80 patients with IAH were selected and divided into observation group and control group（n=40）according to random number table method.The observation group was given 3d CBP therapy.The control group was given conventional treatment.The mean arterial pressure （MAP ）,IAP and abdominal perfusion pressure （APP ） were detected.The number of gastrointestinal symptoms was observed,sequential organ failure score（SOFA score）was used to assess the organ function of the two groups before and after treatment.Results The MAP,IAP,APP,SOFA score of the two groups before treatment had no statistically significant differences（P〉0.05）.The MAP of the two groups after treat-ment[（88.46 ±8.93）mmHg vs.（87.76 ±8.04）mmHg]had no statistically significant difference（P〉0.05）.The IAP[（9.02 ±1.06）mmHg]and SOFA score[（1.32 ±0.45）]of the observation group after treatment were signifi-cantly lower,the APP [（85.34 ±7.59）mmHg]was obviously higher than before treatment and the control group [（19.54 ±4.23）mmHg,（5.24 ±2.05）points,（70.76 ±6.43）mmHg],the differences were statistically significant （t=3.575,2.855,3.274,3.563,3.114,3.782,all P〈0.05）.Before treatment,the number of the gastrointestinal symptoms of the two groups[（44.56 ±8.53）times vs.（45.32 ±8.21）times]had no statistically significant difference （P〉0.05）.The number of gastrointestinal symptoms of the observation group after treatment [（6.54 ±2.24）times] was obviously lower than before treatment and the control group [（15.45 ±4.43）times],the difference was statisti-cally significant（t =3.022,P〈0.05 ）.The 30 d and 60 d survival rates of the observation group were 87.5%（35/40）and 65%（26/40）,which of the control group were 80.0%（32/40）and 55%（22/40）,although which of＆am

关 键 词：血液滤过 压力 胃肠活动 

分 类 号：R459.5[医药卫生—治疗学]