膀胱灌注量对重症患者经膀胱腹内压测量的影响

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。

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

Objective To examine the impact of bladder infusion volumes on the measurement of transvesical intra-abdominal 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.