腹内压检测在危重症患者诊断与治疗中的价值

目的探讨腹内压(IAP)检测在临床危重病患者诊断和治疗中的作用。方法用膀胱测压法对256例患者检测腹内压,分别记录每例患者入院时和入院后d1、d2、d3IAP值,对数据进行汇总与分析。结果 256例患者中,内科腹内压﹤10mmHg者12例、10～14mmHg17例、15～24mmHg14例、25～34mmHg11例、≥35mmHg15例;外科腹内压﹤10mmHg者42例、10～14mmHg21例、15～24mmHg67例、25～34mmHg39例、≥35mmHg18例;内、外科患者IAP平均值分别为(15.8±4.2)mmHg和(17.3±5.7)mmHg,其差异有统计学意义(t=1.9867,P﹤0.05);对33例腹内压≥35mmHg的17患者行手术减压治疗,死亡5例,非手术治疗的16例患者均死亡,差异有统计学意义(χ2=14.83,P=0.0001);死亡组患者31例,腹内压平均值为(31.7±3.9)mmHg,存活组患者225例,腹内压平均值为(14.8±3.2)mmHg,其差异有统计学意义(t=26.8092,P=0.001)。结论腹内压高低与患者病情及预后有密切关系,对重症患者入院后进行腹内压测定有助于病情的评估和预后判断。

The value of intra-abdominal pressure test in diagnosis and treatment of serious illness patients

OBJECTIVE To explore the value of intra-abdominal pertension(IAH)detect in diagnosis and therapy of Serious illness patients. METHODS The intra-abdominal?pressure of 256 cases were detected with test pressure of the bladder,and recored the IAP at the time of 1,2 and 3 days before and after being hospitalized. RESULTS Among 256 cases patients,12 cases showed medical INH ﹤10mm Hg,17 cases showed 10-14mm Hg,14 cases showed 15-24mm Hg,11 cases showed 25-34mm Hg,15 cases showed ≥35mm Hg,42 cases showed surgical INH ﹤10mm Hg,21 cases showed 10～14mm Hg,67 cases showed 15-24mm Hg,39 cases showed 25-34mm Hg and 18 cases showed ≥35mm Hg;The medical and surgical cases of the INH average values were(15.8 ± 4.2)mm Hg and(17.3 ± 5.7)mm Hg,and there was significant difference(t = 1.986 7,P﹤0.05). Among 33 cases showed INH ≥35mm Hg,17 cases were taken surgery for pressure-relief treatment,and 5 cases died. 16 cases without operation pressure-relief died,there was significant difference(χ2 = 14.83,P = 0.0001);31 died cases showed the average INH value was(31.7±3.9)mm Hg,and 225 cases patients survived and with the average INH of(31.7±3.9)mm Hg. There was significant difference between groups(t = 26.8092,P = 0.001). CONCLUSON Higher or lower intra-abdominal?pressure had closely association with illness status and its prognosis serious,and the intra-abdominal?pressure is helpful for disease assessment and prognosis.