多功能直肠置管在腹腔间室综合征治疗中的应用

Study on the application of multifunctional intrarectal catheter in abdominal compartment syndrome

目的研究多功能直肠置管在腹腔间室综合征患者中应用时降低腹腔内压力的作用。方法选择我科近3年应用多功能直肠置管进行规范肠腔减压治疗的ACS重症患者20例,比较治疗前后的腹内压,以配对资料的t检验证实该方法对于ACS患者降低腹内压的治疗效果。结果 20例ACS患者中存活16例,死亡4例。使用多功能直肠置管行规范化腹腔减压治疗后,ACS患者腹内压下降幅度至少为4mmHg。结论本研究证实基础疾病的种类及严重程度对预后影响很大,ACS患者的病因根治与否对于其预后有决定意义。多功能直肠置管规范化治疗对于腹内压≤30mmHg的Ⅰ型(胃肠型)ACS患者降低腹内压、改善脏器血液灌注的治疗效果明显,可以作为该类患者的常规保守治疗手段,在腹腔内高压的早期即可使用。

Objective To sduty on the application of multifunctional intrarectal catheter in abdominal compartment syndrome for decreasing intra abdominal pressure. Methods Twenty patients with ACS who were from the Intensive Cafe Unit in the First Hospital of Hohhot experienced the application of multifunctional intrarectal catheter for decreasing intra abdominal pressure. We collected the data of intra abdominal pressure for them before and after they experienced the application of multifunctional intrarectal catheter, compared with these data, dealt these data with statistical method, and then knew the therapeutic effect about the application of multifunctional intrarectal catheter in abdominal compartment syndrome for decreasing intra abdominal pressure. Results Sixteen patients survived, and four patients died between the twenty patients with ACS. After experienced the application of multifunctional intrarectal catheter for decreasing intra abdominal pressure, the twenty patients with ACS got the results that totally their intra abdominal pressure reduced 4 mmHg at least. Conclusion We know that primary disease sort can decide the results that the ACS patients survive or die, primary disease is severe or not can decide the ACS patients survive how long. The application of multifunctional intrarectal catheter in I type ACS patients whose intra abdominal pressure≤30mmHg can efficiently decrease their intra abdominal pressure and improve the blood perfusion of abdominal organ. The application of multifunctional intrarectal catheter in I type ACS patients whose intra abdominal pressure 〈30mmHg can be routine treatment for these patients even when they are only in the initial stage of intra-abdominal hvoertension.