腹股沟斜疝患者腹腔内压力的临床研究

目的观察不同仰卧角度下、腹部加压动作前后斜疝患者腹内压力（intra-abdominal pressure,IAP）及其变化特点,并探讨其临床意义。方法 2009年8月至2010年4月,腹股沟斜疝患者与因其他病住院、手术停留尿管患者各30例,均为男性,分别为实验（斜疝）组及对照组。通过测量膀胱内压力,测量并比较不同仰卧角度（0°、15°、30°、45°、60°、75°及站立）时患者与对照组在静息状态及做腹内加压动作时腹腔内压力。结果随着仰卧角度的增大及站立,实验组及对照组中静息、加压两种情况下,腹内压值均随之升高,各角度间的平均值比较均有明显统计学差异（P〈0.05）;并且实验组中加压前后的腹内压差平均值也随着仰卧角度的增大而增加,且较正常对照组的增加更加明显,各角度间的平均值比较均有明显统计学差异（P〈0.05）。结论斜疝患者的IAP随着仰卧角度增加较正常人更易升高,是斜疝的形成原因之一。

Clinical Study on Intra-abdominal Pressure in Patients with Indirect Inguinal Hernia

Objective To investigate intra-abdominal pressure（IAP） and changing characteristics in patients with indirect inguinal hernia at different supine angles and before and after abdominal pressure movement,and to explore the clinical significance of IAP.Methods From August 2009 to April 2010,there were 30 patients with indirect inguinal hernia and 30 patients with hospitalization for other diseases and indwelling catheter respectively,all the patients were male and they were divided into the experimental（oblique hernia） group and control group respectively.According to intravesical pressure by measurement,at different supine angles（0°,15°,30°,45°,60°,75° and vertical）,intraperitoneal pressure of patients was compared with control group when they were at static status and pressurized intraperitoneal.Results With the increasing of supine angles,IAP was higher under the static and pressure conditions in experimental group and control group,the average among the angles had significantly statistical difference（P0.05）;moreover,in experimental group the average of intra-abdominal pressure difference of pre and post pressurization was increased with supine angles,compared with the control group,increasing amplitude was more obvious,comparison of average value among the angles had significantly statistical difference（P0.05）.Conclusion IAP in patients with indirect inguinal hernia is easier to increase than normal human with the the increasing of supine angles,which is one of the factors that cause indirect inguinal hernia.