重度以上烧伤患者合并腹腔间隙综合征与合并休克的区别与联系

The Relationship and Differentiation between Abdominal Compartment Syndrome and Shock in Severely Burned Patients

目的：研究重度以上烧伤患者合并腹腔间隙综合征与合并休克的区别与联系. 方法：收集7例确诊为重度以上烧伤且合并腹腔间隙综合征的病人的临床诊治资料,整理烧伤合并腹腔间隙综合征患者的临床诊治方法. 结果：重度以上烧伤合并腹腔间隙综合征的病人可能出现如下临床表现：心率增快、中心静脉压升高、心输出量降低、低血压、腹胀、呼吸困难、低氧血症和高碳酸血症、少尿或无尿、膀胱压增高等.腹腔减压术后,患者心率增快、低血压、腹胀、少尿、呼吸困难等症状得到缓解. 结论：腹腔间隙综合征的临床表现与休克有部分相似,但二者的病理生理基础及治疗原则却不相同.重度及特重烧伤患者在抗休克补液时可能引起合并腹腔间隙综合征,某些因素可导致腹腔间隙综合征被误诊与漏诊.

Objective to research the relationship and differentiation between abdominal compartment syndrome （ACS） and shock. Methods The clinical data of 7 seriously burned patients with the complication of ACS were collected. The diagnostic evidences and the therapy methods of these patients were analyzed. Results The seriously burned patients with the complication of ACS had the clinical manifestations such as increased heart rate, increased central venous pressure, reduced cardiac output, hypopiesia, abdominal distention, anhelation, hypoxemia, hypereapnla, oliguresis, anuresis, increased urinary bladder pressure. After the abdominal decompression procedure, the patients＂ clinical manifestations such as increased heart rate, hypopiesia, abdominal distention, oliguresis, anhelation were improved. Conclusions The clinical manifestations of ACS were partly similar to shock. But the pathological procedure and the treatment principles were different between ACS and shock. In a seriously burned patient, the excessively transfused fluid may cause ACS, and the diagnosis of ACS is likely to be mistaked or missed by some reasons.