中国冶金工业医学杂志

腹部大手术后液体平衡及SIRS与腹腔内压力变化的关系

分类号：R 656

出版年,卷(期):页码：2010,27(5):503-505

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 24 h 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%，24 h 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，24 h 液体平衡以及SIRS是发生IAH的危险因素。

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，P＜0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(P＜0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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参考文献：

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