股静脉测压法和膀胱测压法在危重患者腹内压监测中的比较

目的：比较股静脉测压法和膀胱测压法在危重患者腹内压（IAP）监测中的应用价值.方法：对2013年1-6月住院治疗的20例ICU重症患者,分别使用两种测压方法进行IAP监测,均每8 h 1次,连续测定3 d,每次随机选择两种方法的测量顺序,共测量720次,比较两种测压法在读数精准性、测压数值、操作时间、并发症和医护人员满意度等方面的异同.结果：股静脉测压法所测压力数值与膀胱测压法相近（14.14±4.33）mmHg比（12.91±4.75）mmHg,P〉0.05];但是股静脉测压法的操作时间（57.94±19.00）s]较膀胱测压法更短（112.49±27.07）s,P〈0.05];股静脉测压法读数精准率（84.44%）较膀胱测压法（49.44%）高（P〈0.01）,操作并发症低至1.1%（4例次）,远低于膀胱测压法的5.3%（19例次,P〈0.05）;医护人员满意度达（3.90±0.26）分,优于膀胱测压法（2.48±0.19）分,P〈0.01].结论：相对于膀胱测压法而言,股静脉测压法具有测压值相似、操作时间短、读数精准度高、操作并发症少、接纳度高等优点,值得在危重患者IAP监测中推广.

Comparison measurement of femoral venous pressure and intravesical pressure in monitoring intra-abdominal pressure in critical care patients

Objective..To investigate the difference in value of measuring femoral venous pressure and intravesical pressure on monitoring intra-abdominal pressure （IAP） in critically ill patients. Methods： IAP measurement was performed in 20 critical care patients who were hospitalized from January 2013 to June 2013. Two methods were used to monitor IAP 3 times everyday on 3 consecutive days, and they were performed randomly 720 times. The accuracy, value, time for measurement, complication ,and acceptance rate of femoral venous pressure by medical personnel in monitoring IAP were compared to measurement of intravesieal pressure. Results：The values of femoral venous pressure were approximate to the values of intravesicle pressure E（14. 14±4.33）mmHg vs. （12.91± 4. 75） mmHg ,P 〉0.05]. However, the operating time for measuring femoral venous pressure was （57.94± 19.00）s, and it was shorter than that of intravesical pressure measurement - （112.49±27.07） s,P〈0. 051. The accurate rate of femoral venous pressure was 84. 44%, and it was higher than the latter（49.44% ,P〈0. 01）. The incidence of complications of femoral venous pressure was nearly 1.10% and much lower than the latter（5.3 %, P〈 0.05）. The acceptance rate of performing femoral venous pressure by medical personnel was higher than that of the latter（3.90＋0.26 vs. 2.48~0.19,P~0.01）. Conclusions;Femoral venous pressure measurement is advantageous compared to intravesicle pressure measurement on monitoring IAP, as it is were accurate with similar value, shorter operating time, less complications, and higher acceptance rate by medical staff. Femoral venous pressure could be generalized in critical care patients for IAP monitor.