ICU腹内压监测对肠功能障碍患者临床意义.docVIP

ICU腹内压监测对肠功能障碍患者临床意义 　　[摘要] 目的 探讨ICU腹内压监测对肠功能障碍患者的临床意义。方法 选择2013年1月―2015年6月该院重症监护室收治的肠梗阻患者80例，所有患者均行外科开腹手术行肠切除肠吻合治疗，按照随机数字法分为两组，各40例，其中观察组进行监测膀胱内压力测定反应腹腔内压力变化，对照组则实施常规治疗，未进行腹腔内压力监测。比较两组治疗期间腹围增加情况、发生腹胀腹痛、恶心呕吐情况，统计两组干预前后APACHEⅡ评分情况。 结果 观察组腹围增加值5.0%显著小于对照组35.0%（P0.05），干预后，观察组APACHEⅡ评分显著低于对照组（P0.05）。结论 有效监测患者腹腔内压力，能显著减少危重患者治疗期间消化道不适，提高临床治疗效果，改善患者预后。 　　[关键词] 重症监护室；腹内压监测；肠功能障碍 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）03（b）-0025-03 　　[Abstract] Objective To investigate the clinical significance of intra-abdominal pressure monitoring in patients with intestinal dysfunction in the ICU. Methods 80 cases with intestinal obstruction underwent open intestinal resection and anastomosis in the ICU in our hospital from January 2013 to June 2015 were selected and randomly divided into two groups， the observation group and the control group， with 40 cases in each. Patients in the observation group were treated by bladder pressure measurement for estimating the intra-abdominal pressure， while those in the control group were given the conventional treatment without the intra-abdominal pressure monitoring. The increase in abdominal circumference， incidence of abdominal distention and pain， nausea and vomiting during treatment were compared between the two groups. And the APACHEⅡ scores were counted in both groups before and after intervention. Results Increased abdominal girth in the observation group was significantly lower than control group （P0.05）， but after the intervention， the APACHEⅡ scores in the observation group were significantly lower than those in the control group（P0.05）. Conclusion Effective intra-abdominal pressure monitoring can significantly reduce the gastrointestinal discomfort in severe patients during the treatment as well as improve the clinical effect and prognosis. 　　[Key words] Intensive care unit； Intra-abdominal pressure monitoring； Intestinal dysfunction 　　当腹腔内压力超过10 cmH2O时临床评定为腹腔内压力升高，严重的腹内压升高将影响腹腔脏器血流引起器官组织功能障碍，甚至导致腹腔筋膜室综合征，诱发多器官功能障碍[1]。作为一种严重的