腹腔压力监测---腹腔高压及腹间隔室综和征的诊治精编版.pptVIP

Figure 9. Comparison of the effects of intraabdominal hypertension (IAH) on baseline (BL) static total respiratory system compliance (Cstat). The results from Quintel et al. [51??] were given for normal lungs (NL) and after oleic acid (OA) lung injury. Data adapted from [51??,53,54]. In summary IAH decreases renal perfusion pressure, the filtration gradient, and renal blood flow. Oliguria develops, tubular dysfunction increases, glomerular filtration rate drops, renal vascular resistance increases, renal vein and ureter compression increases, renin, aldosteron and antidiuretic hormone levels increase, while adrenal blood flow usually remains preserved Fig. 2. Urine output (UO) (mean SD) of pigs with normal (control) and elevated intra-abdominal pressure (IAP-30). All animals of the study group developed renal failure. Time intervals changed from 1 to 4 hours after a break at 4 hours. *Significant difference compared with baseline value according to paired t test, p 0.001 (IAP-30 after 3 hours) and p 0.008 (control after 24 hours). ?Significant difference compared with corresponding control value according to unpaired t test, p 0.001 after 3 hours. ANOVA and post hoc analysis: p 0.0001. 腹腔压力的升高从一个方面加速了手术切口并发症的发生。 而腹壁组织的缺血和水肿常同腹壁手术切口的并发症有非常密切的关系 有效控制术后病人IAH，是预防术后伤口感染、延迟愈合及伤口裂开的重要环节。 CPP下降，颅内损害加重 These results suggest that raised ICP resulting from a rise in IAP is mediated by raised intrathoracic pressure. The hypothesis was that IAH causes an upward displacement of the diaphragm, resulting in increased pleural pressure, increased central venous pressure, impaired cerebral venous outflow and intracranial congestion. Figure 6. Correlation graph of intraabdominal pressure (IAP) and intracranial pressure (ICP) in eight ICU patients Table 3 Parameters Before and After Abdominal Decompression ? Utilizes a femoral central venous catheter ? Places patient at risk of indwelling catheter-related infection and sepsis ? Correlates well with intravesicular pressure ?