腹腔间隔室综合征21例诊治分析

目的探讨腹腔间隔室综合征(ACS)的临床表现和诊治方法。方法回顾性分析我院2000年1月～2006年5月收治的21例ACS患者的临床资料和治疗结果。结果腹部外伤8例,重症急性胰腺炎6例,低位肠梗阻5例,腹腔感染3例;患者均有明显腹胀伴腹壁紧张度增加。早期手术治疗(<24h内)11例,延期手术治疗(≥24h)5例,非手术治疗5例。16例手术患者手术前后膀胱压值间差别有统计学意义(P<0.01)。早期手术治愈率为9/11,延期手术5例中治愈3例,非手术治疗5例中死亡4例。结论ACS多见于外科危重患者,常被原发疾病所掩盖,及时诊断、早期实行腹腔减压手术是提高治愈率的关键。

Experience of Diagnosis and Treatment on Abdominal Compartment Syndrome in 21 Cases

Objective To investigate the clinical manifestations as well as diagnosis and treatment methods of abdominal compartment syndrome.Methods Twenty-two cases were treated in our hospital from January 2000 to May 2006,and a retrospective study was used to analyze the clinical data of them.Results Abdominal trauma in 8 cases,severe acute pancreatitis in 6 cases,lower intestinal obstruction in 5 cases and severe abdominal infection in 3 cases.All the patients manifested marked abdominal distension and increased abdominal wall intensity.Eleven cases underwent surgery within 24 hours,5 cases underwent surgery over 24 hours and 5 cases received non-operative therapy.There were significant differences before and after the operation in 16 cases in vesical pressure values.The cure rate of patients received early treatment was 9/11 and that of patients received delayed treatment was 3/5,the mortality rate of those received non-operative therapy was 4/5.Conclusion ACS is mostly seen in severe surgical patients,and generally covered by the primary disorder,so the timely diagnosis of it and early decompressive laparotomy are the key to improve the cure rate.