妇产科疾病合并腹腔闭室综合征35例分析

Analysis of 35 cases of obstetric and gynecologic disease complicated with abdominal closed syndrome.

目的 对妇产科疾病并发腹腔闭室综合征 (ACS) 35例患者腹腔减压的治疗作用进行观察 ,并探讨ACS与多器官功能障碍综合征 (MODS)的关系。方法 通过测量膀胱压力 (IBP)动态观察 35例妇产科疾病并发ACS患者的腹腔内压力 (LAP)与治疗效果的关系 ,及对患者各脏器功能的监测 ,了解ACS与MODS的关系。结果 35例患者治疗前IBP(3 5 5± 1 1 5 )kPa ,显著高于治疗后IBP(1 1 5± 0 35 2 )kPa(P <0 0 1 ) ;循环指标中HR及CVP在治疗后较治疗前显著降低 (P <0 0 1 ) ;呼吸指标RR在治疗前后显著改善 ,PaO2 明显上升 (P <0 0 1 )。本组治愈 30例 ,5例因并发MODS死亡。结论 妇产科疾病在一定条件下可并发ACS ,并促使多个脏器发生功能障碍 ,而导致MODS ,若不及时处理 ,低氧血症逐步加重 。

Objective To observe the effects of abdominal decompression on the treatment of obstetric and gynecologic disease complicated with abdominal closed syndrome(ACS),and further discuss the relationship between ACS and multiple organs dysfunction syndrome(MODS).Methods Intraabdominal pressure of patients with ACS was dynamicly measured by intrabladder pressure(IBP)before and after decompression,meanwhile,the function of major organs were monitored.Results IBP before treatment (3\^55±1\^15kPa) was significantly higher than that after treatmnet(1\^15±0\^352kPa)(P<0\^01).The heart rate and CVP significantly lowered after decompression(P<0\^01);Respiratory rate improved significantly and PaO\-2 increased markedly after decompression(P<0\^01).30 patients were cured and 5 patients died from MODS in our study.Conclusion The diseases of obstetrics and gynecology can be associated with ACS and induce MODS,so the treatment should be early and effective to avoid the MODS and patient's death.