腹内压监测在急腹症中应用.docVIP

腹内压监测在急腹症中应用 　　【摘要】 目的 探讨腹内压监测在急腹症患者诊疗中的应用价值。方法 212例急腹症患者， 通过测定膀胱压力测定腹内压， 并依据腹内压测定结果确定治疗方案；对腹内压为Ⅳ级的患者， 根据患者是否愿意进行手术减压治疗分为减压组（17例）和非减压组（16例）。测定患者腹内压测定前后的心率、血压、末梢血氧饱和度（SpO2）以及呼吸频率差异， 治疗前后中心静脉压（CVP）、氧合指数（PaO2/FiO2）以及腹内压差异。结果 腹内压监测前后患者心率、血压、末梢SpO2以及呼吸频率无明显变化， 差异无统计学意义（P0.05）；治疗后患者CVP、腹内压较治疗前明显降低（P0.05）；PaO2/FiO2较治疗前明显升高（P0.05）。对腹内压为Ⅳ级的患者， 减压组临床治疗效果明显优于非减压组， 差异具有统计学意义（P0.05）。结论 腹内压监测对急腹症患者各项生命指标均无明显影响， 依据腹内压监测结果进行对症治疗可提升急腹症患者预后质量。 　　【关键词】 腹内压监测；急腹症；临床疗效 　　DOI：10.14163/j.cnki.11-5547/r.2015.11.009 　　Application of intra-abdominal pressure monitoring in acute abdomen WU Gui-cai， LI Shi-zhuo. Enping City People’s Hospital， Enping 529400， China 　　【Abstract】 Objective To investigate the application value of intra-abdominal pressure monitoring in diagnosis and treatment of acute abdomen patients. Methods A total of 212 acute abdomen patients received urinary bladder pressure assessment for intra-abdominal pressure assessment. Their assessment results were taken for establishment of treatment plans. Patients with Ⅳ grade of intra-abdominal pressure were divided into decompression group （17 cases） and non-decompression group （16 cases） according to their willingness for decompression. Assessments of heart rate， blood pressure， peripheral blood oxygen saturation （SpO2）， and respiratory rate before and after intra-abdominal pressure assessment were made， as well as that of central venous pressure （CVP）， oxygenation index （PaO2/FiO2） and intra-abdominal pressure differences. Results The differences of heart rate， blood pressure， peripheral SpO2， and respiratory rate were not statistically significant before and after intra-abdominal pressure monitoring （P0.05）. After treatment， CVP and intra-abdominal pressure were obviously lower than those before treatment （P0.05）， and PaO2/FiO2 was increased obviously （P0.05）. The decompression group had much better clinical effect than the non-decompression group in patients with Ⅳ grade of intra-abdominal pressure （P0.05）. Conclusion Int