危重病患者胃肠道症状与腹腔间室综合征的相关性分析

Correlative study on gastrointestinal symptoms of severe cases and Abdominal compartment syndrome

目的探讨危重病患者胃肠道症状与腹腔间室综合征间的相关性,提高对危重病患者早期胃肠功能改变的识别与监护。方法采用描述性研究的方法,对384例危重患者胃肠道症状作分类描述。采用Logistic回归分析对其中发生腹腔间室综合征的46例进行危险因素分析。结果①46例并发腹腔间室综合征患者的胃肠道症状其中,恶心呕吐1例(2.2%),腹胀腹痛45例(97.8%),肠鸣音减弱45例(97.8%),腹泻2例(4.3%),便秘45例(97.8%)。②单因素Logistic回归分析显示,对发生腹腔间室综合征有统计学意义(P<0.01)的胃肠道症状为,腹胀腹痛、肠鸣音减弱、便秘3项。多因素非条件逐步Logistic回归分析显示,腹腔间室综合征危险因素为腹胀腹痛(0R=259.106)、肠鸣音减弱(0R=30.16,P<0.01)、便秘(0R=29.28,P<0.01)。结论危重病患者胃肠道症状与腹腔间室综合征有相关性,临床护士应重视早期的胃肠道功能监测,并采取有效措施,降低腹腔间室综合征的发生率。

Objective To explore the correlation of gastrointestinal symptom of severe cases and abdominal compartment syndrome （ACS）,improve monitor technique. Methods Using descriptive study to do classified description according to the distribution of 384 severe cases＇ gastrointestinal symptom and using regressive analysis to analyze the dangerous factors of 46 cases who suffered ACS. Results ①The rate of gastrointestinal symptom of 46 cases with ACS：one case with nausea and vomiting occupied 2.2%,45 cases with abdominal distension and pain occupied 97.8%,45 cases with bowel sound occupied 97.8%,2 cases with diarrhea occupied 4.3%,45 cases with constipation occupied 97.8%. ②According to the single factor lo- gistic regressive analysis shows statistical significant symptoms relating to ACS as follows ：abdominal distension and pain,bowel sound decline and constipation,etc. With multi-factors unconditional progressively logistic regressive analysis shows：the first dangerous factor of ACS is abdominal distension and pain（OR=259.106）,then is bowel sound decline. Conclusion The correlation exists between the gastrointestinal symptoms and ACS. The clinical nurses should pay attention to the monitor of gastrointestinal function so that the incidence of ACS can be reduced through promoting monitor skills.