膀胱压力监测在移植肾间隔室综合征防治中的意义

目的 探讨膀胱压力(UBP)监测在术后腹胀所致移植肾间隔室综合征(RACS)中的意义.方法 监测59例亲属肾移植受者术后0、12、24、48、72 h膀胱压力,结合同一时间点腹胀程度及尿量变化,分析三者间关系.结果 57例患者术后72 h内出现腹胀,且随着腹胀程度不同尿量亦有所减少,平均减少(13.44±11.11)%;而UBP在4～36 cm H2O[(15.40±6.99)cm H2O].腹胀程度与UBP升高呈正相关(P＜0.05),而UBP与尿量变化呈负相关(P＜0.05).随着腹胀缓解,UBP可降至10 cm H2O以下,多数患者尿量改善,仅4例发生RACS.结论 UBP监测是早期发现RACS的有效手段,及时进行处理可有效减少此并发症.

Clinical significance of monitoring urinary bladder pressure for renal allograft compartment syndrome

Objective To investigate the role of monitoring urinary bladder pressure (UBP) in renal allograft compartment syndrome (RACS) caused by post-transplant abdominal distention. Methods The level of UBP and change of urine output were monitored in combination with judgment of the degree of abdominal distention at five time points, including0, 12, 24, 48, 72 h postoperatively, in59 relative renal transplant recipients. The relationships among above three factors were analyzed. Results Fifty-seven cases suffered from varying degrees of abdominal distention within 72 h postoperatively. The urine output was decreased to some extent with the aggravation of abdominal distention. The percentage of the urine output mean decrease was (13.44 ± 11.11) % , meanwhile the range of UBP was 4 to 36 cm H2O [ (15.40 ± 6.99) cm H20]. There was a positive correlation between the level of UBP and severity of abdominal distention (P < 0.05 ) and a negative correlation between the change of urine output and the level of UBP ( P < 0.05 ). In the majority of cases, the urine output and the level of UBP were improved with the alleviation of abdominal distention. Only four cases suffered from RACS. Conclusion Monitoring of UBP is an effective way to detect RACS in the early stage after kidney transplantation. Early intervention to high risk group is pivotal to effectively reduce morbidity of RACS.