膀胱压监测在危重患者监护中的应用效果

Effect of urinary bladder pressure inspection in critical patients monitoring

目的通过膀胱压监测,及时发现腹腔高压,给予干预治疗、护理,监测、预防腹腔间室综合征的发生与发展,降低患者病死率,提高危重患者监护水平。方法采用单纯随机抽样法,实验组45例采取常规重症监护和膀胱压力(UBP)监测,UBP升高者给予干预措施;对照组43例进行常规重症监护和治疗。两组均观察中心静脉压(CVP)、心率(HR)、平均动脉压(MAP)、呼吸(R)、脉搏血氧饱和度(SpO_2)、尿量、肾功能等指标。结果实验组在CVP、HR、MAP、R、SpO_2、尿量、肾功能等的变化和预后、意识转归、并发症等与对照组比较有统计学意义(P<0.05)。结论常规重症监护+UBP监测能及时发现腹内高压(LAH),采取干预性措施,可以预防腹腔间隔室综合征(ACS)和多脏器功能不全(MODS)的发生,降低ACS患者病死率,可作为综合重症监护治疗病房常规监测内容。

Objective To detect intra-abdominal hypertention in time by urinary bladder pressure inspection, accordingly release treatment and nursing, inspect and prevent abdominal compartment syndrome, decrease fatality rate, and advance in critical patient monitoring. Method Random sampling. Experimental group consists of 45 samples with routine intense care and UBP inspection, and treatment to elevation of UBP. Matched group consists of 43 samples with routine intense care and treatment. Both of the two groups inspect the indexes including CVP, HR, MAP, R, SpO2, urine output and kidney function etc. Result The experimental group and the matched group have statistical significance of the changes of CVP, HR, MAP, R, SpO2, urine output and kidney function etc, the outcomes of consciousness, and the complications （P〈0.05）. Conclusion Routine intense care plus UBP inspection can be treated as a routine inspection in ICU which is able to detect IAH in time and intervene accordingly, prevent ACS and MODS, and decrease fatality rate of ACS patients.