不同膀胱灌注量对腹腔内高压患者经膀胱腹腔内压力测定值影响.docVIP

不同膀胱灌注量对腹腔内高压患者经膀胱腹腔内压力测定值的影响 　　[摘要] 目的 探讨分析不同膀胱灌注量对腹腔内高压（IAH）患者经膀胱腹腔内压力测定值的影响。 方法 选取我院收治的52例IAH患者作为本次研究对象，所有患者的腹腔内压力（IAP）均超过12mm Hg，分别在10～60mL的膀胱灌注量下进行IAP测定，间隔灌注量为10mL，间隔时间为3h。 结果 当膀胱灌注量为30mL，IAP测量值超过20mm Hg的有66次，12～20mm Hg之间的有288次；以这组数据作为参考值，膀胱灌注量为10mL或20mL时，患者的IAP测量数据与参考值的差异无统计学意义（P0.05）；当膀胱灌注量为40或50mL，患者的IAP测量数据与参考值的差异有统计学意义（P0.05）；当膀胱灌注量为60mL时，患者的IAP测量数据与参考值的差异有统计学意义（P0.05）。 结论 当膀胱灌注量超过40mL时，可能导致IAP测量值出现较大误差率，明显高于患者的实际测量值，故临床上经膀胱检测IAP时的膀胱灌注量保持在30mL为宜。 　　[关键词] 腹腔内高压；膀胱灌注量；腹内压；膀胱压力监测 　　[中图分类号] R656 [文献标识码] A [文章编号] 2095-0616（2017）05-152-03 　　[Abstract] Objective To explore the impact of different bladder perfusion to Intravesical pressure measurement value of intra-abdominal hypertension patients. Methods 52 cases of IAH patients cured in our hospital were selected as the study objects.The intra-abdominal pressure （IAP） of all patients was more than 12mmHg.IAP determination was under intravesical instillation of 10-60mL， the interval perfusion was 10mL， and the interval was 3h. Results There were 66 cases of intravesical instillation less than 30 mL and IAP value more than 20mm Hg and 288 cases of IAP value within 12-20mm Hg.Taking this set of data as reference value，there was no significant difference between the IAP data and the reference value of the patients with bladder perfusion of 10mL or 20mL（P0.05）. When the bladder perfusion was 40 or 50mL， the difference between the IAP data and the reference value was statistically significant（P0.05）. When the bladder perfusion was 60mL， there was significant difference between the IAP data and the reference value （P0.05）. Conclusion When the bladder perfusion exceeds 40mL，it may lead to a large error rate of IAP measurement，which is significantly higher than the actual measured value.Therefore，the clinical application of bladder IAP detection of bladder perfusion in 30mL is appropriate. 　　[Key words] Intra-abdominal hypertension；Bladder perfusion；Intra-abdominal pressure；Bladder pressure monitoring 　　腹腔内压力（IAP