腹腔压力与急性呼吸窘迫综合征患者病情相关性分析  

An analysis of correlation of intra-abdominal pressure with severity and prognosis in patients with acute respiratory distress syndrome

作　　者：徐金全[1] 刚丽[1] XU Jinquan;GANG Li(Department of Emergency Intensive Care Unit,Affiliated Zhongshan Hospital,Dalian University,Dalian 116001,CHINA)

机构地区：[1]大连大学附属中山医院急诊ICU,辽宁116001

出　　处：《江苏医药》2021年第9期922-925,共4页Jiangsu Medical Journal

基　　金：大连市卫生计生委资助项目(1511100)。

摘　　要：目的分析腹腔压力(IAP)与急性呼吸窘迫综合征(ARDS)患者病情严重程度及预后的相关性。方法回顾性分析32例ARDS患者的临床资料,根据柏林标准分为轻度组(9例)、中度组(12例)和重度组(11例),按照预后分为生存组(20例)和死亡组(12例)。记录各组患者急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分,采用经尿道膀胱内压力测定法检测入院后不同时间点IAP,并分析IAP对ARDS患者生存状况的预测价值。结果随着病情加重,IAP和APACHEⅡ评分逐渐升高,三组间APACHEⅡ评分和各时间点IAP比较差异均有统计学意义(P<0.05)。生存组APACHEⅡ评分和各时间点IAP低于死亡组(P<0.05)。IAP对ARDS患者生存预测的曲线下面积为0.796[95%CI(0.633~0.959),P<0.05];以入院IAP 13.5 mmHg为最佳截断值,其对ARDS患者预后评估的灵敏度和特异度分别为83.3%和45.0%。结论 IAP与ARDS患者病情严重程度及预后密切相关。Objective To analyze the correlation of intra-abdominal pressure(IAP) with the severity and prognosis in the patients with acute respiratory distress syndrome(ARDS).MethodsThe clinical data of 32 patients with ARDS were retrospectively analyzed.The patients were divided into three groups of mild(9 cases),moderate(12 cases) and severe(11 cases) according to the Berlin standard, and also then divided into two groups of survival(20 cases) and death(12 cases) on the basis of prognosis.The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score was recorded in each group.The IAP at different time points after admission was detected by transurethral bladder pressure measurement.The predictive value of IAP in the living status of the patients with ARDS was analyzed.Results The IAP and APACHEⅡ score were increased as the illness got worse, and there were significant differences in APACHEⅡ score and IAP at different time points among three groups of mild, moderate and severe(P<0.05).The APACHEⅡ score and IAP at different time points in survival group were lower than those in death group(P<0.05).The AUC of IAP in predicting the survival of the patients with ARDS was 0.796 [95% CI(0.633-0.959),P<0.05].Taking IAP 13.5 mmHg as the best cut-off value, the sensitivity and specificity of IAP in evaluating the prognosis of ARDS patients were 83.3% and 45.0%,respectively.Conclusion The IAP is closely correlated with the severity and prognosis of the patients with ARDS.

关 键 词：腹腔压力 急性呼吸窘迫综合征 急性生理学与慢性健康状况评价Ⅱ 

分 类 号：R459[医药卫生—治疗学]