腹部大手术后液体平衡及SIRS与腹腔内压力变化的关系 |
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引用本文: | 吴国刚,刘吉盛,曲畅,张殿红,唐利平,刘兆润,杨辉,陈汉敏. 腹部大手术后液体平衡及SIRS与腹腔内压力变化的关系[J]. 中国冶金工业医学杂志, 2010, 27(5): 503-505 |
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作者姓名: | 吴国刚 刘吉盛 曲畅 张殿红 唐利平 刘兆润 杨辉 陈汉敏 |
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作者单位: | 中国医科大学第八临床学院鞍钢总医院外科,辽宁鞍山,114002 |
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摘 要: | 目的:探讨腹部大手术后腹腔内高压(IAH)的发生率,评估腹腔内压力(IAP)变化与液体平衡及全身性炎症反应综合征(SIRS)的关系。方法:以本院腹部大手术后入IUC监护的57例患者为研究对象,通过膀胱内测压法测量术后连续3天的IAP值、IAP日变化值并记录24h液体平衡,根据ACCP/SCMM的SIRS标准将研究对象分为SIRS组和Non-SIRS组,记录术后3天内每组IAH和Non-IAH患者例数及IAP值。结果:57例患者中术后发生IAH者占32.8%,24h液体平衡与IAP变化呈正关(r1=0.554,r2=0.522,r3=0.571,P〈0.01);SIRS组IAH发生例数多于Non-SIRS组,并且IAP值高于Non-SIRS组(P〈0.01)。结论:IAH多发生在腹部大手术后,24h液体平衡以及SIRS是发生IAH的危险因素。
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关 键 词: | 腹腔内压力 腹腔内高压 液体平衡 全身性炎症反应综合征 |
The relation of fluid balance on intra-abdominal pressure after major abdominal surgery |
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Affiliation: | WU Guo-gang,LIU Ji-sheng,QU Chang,et al.Department General Surgery.General Hospital of Anshan Irion and Steel,Anshan 114002 |
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Abstract: | Objective:The objectives of this study were to determine the incidence of intra-abdominal hypertension in patients after major abdominal surgery and to evaluate the correlation of intra-abdominal pressure with fluid balance and systemic inflammatory response syndrome.Methods:57 patients,admitted to ICU of our hospital after major abdominal surgery,were included into the study.Through measurement of bladder pressure measured the IAP value,IAP changes in value and record the 24 h day fluid balance of the 3 consecutive days,according to ACCP/SCMM of SIRS standard subjects were divided into SIRS group and the Non-SIRS group,recorded after 3 days not only the number of IAH and Non-IAH patients but also the IAP values.Results:57 patients were included into the study.Intra-abdominal hypertension was diagnosed in about 32.8% of the patients in the early postoperative period.The study showed a significant positive correlation between 24-hour fluid balance and daily changes in intra-abdominal pressure(r1=0.554,r2=0.522,r3=0.571,P0.01).A significant association was also seen between the number of positive systemic inflammatory response syndrome criteria and intra-abdominal pressure,and intra-abdominal pressure was significantly higher in patients with systemic inflammatory response syndrome(P0.01).Conclusions:Intra-abdominal hypertension occured commonly in patients after major abdominal surgery,and patients with positive 24-hour fluid balance and/or systemic inflammatory response syndrome were at risk of having higher intra-abdominal hypertension. |
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Keywords: | Intra-abdominal hypertension Intra-abdominal pressure Fluid balance Systemic inflammatory response syndrome |
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