重症患者腹内压监测的临床应用研究

Clinical application of intra-abdominal pressure monitoring in critical care patients

目的探讨重症患者腹内压水平及相关因素。方法采用膀胱压测量法对219例重症患者进行腹内压测定,分为机械通气组与非机械通气组,比较机械通气对腹内压的影响及患者平均动脉压(MAP)、APACHEⅡ评分和TISS-28评分与腹内压的相关性。结果 219例重症患者腹内压平均值为(7.43±3.15)cmH2O,机械通气组腹内压水平高于非机械通气组(P>0.05);腹腔高压组患者的MAP、APACHEⅡ评分和TISS-28评分均高于腹腔低压组(P>0.05)。结论机械通气与否、疾病严重程度对重症患者腹内压水平有影响,应作为常规监测指标。

Objective To investigate the intra-abdominal pressure （IAP） level in critical care patients and the related factors .Methods The urinary bladder pressure （UBP） was used to report IAP of 219 critical care patients in Mechanical ventilation （MV） group and Non-MV group ;to compare the mean artery pres-sure （MAP） ,scores of APACHE Ⅱ and TISS-28 ;reflect the effects of MV and study the relativity be-tween MV and IAP .Results The average IAP was （7 .43 ± 3 .15） cmH2O .The level of IAP in MV group was higher than non-MV group （P 〈0 .01） .The levels of MAP ,scores of APACHE Ⅱ and TISS-28 of the hyper-IAP group were higher than those of the hypo-IAP group （P 〈0 .05） .Conclusion MV and the severity of illness influenced the IAP level of critical care patients .The routine monitoring for IAP in criti-cal care patients should be normalized .