持续腹腔压力监测对腹部损伤引起的腹腔间隙综合征的辅助诊疗价值

Continuous monitoring of intra-abdominal pressure secondary treatment gap value for celiac syndrome caused by abdominal injury

目的探讨持续腹腔压力监测对腹部损伤引起的腹腔间隙综合征的辅助诊疗价值。方法回顾性分析2010年6月至2013年6月于本院治疗的42例腹部损伤引起的腹腔间隙综合征患者的临床资料,分析腹腔内压力与炎性指标及重要脏器功能改变的关系,观察治疗后患者并发症发生情况和死亡率。结果随着腹腔内压力的逐渐升高,红细胞、白细胞、C反应蛋白等炎性指标水平逐渐上升,血压、血氧饱和度、肾血浆流量、肾小球滤过率、24小时尿量等重要脏器功能水平逐渐降低,差异具有显著性(P<0.05);42例患者中8例并发肾衰竭,5例并发心力衰竭,3例并发Ⅱ型呼吸衰竭,1例并发弥散性血管内凝血,根据持续腹腔压力监测早期诊断,积极治疗,最终治愈出院32例,治愈率为76.2%;因多器官功能衰竭抢救无效死亡10例,死亡率为23.8%。结论持续腹腔压力监测能够有效指导腹部损伤引起的腹腔间隙综合征的早期诊断,降低患者的死亡率。

Objective To explore the value of continuing intra-abdominal pressure in the monitoring assisted treatment of abdominal compartment syndrome caused by abdominal injuries. Method The clinical data of 42 cases of abdominal compartment syndrome of abdominal injury occurred patients from June 2010 to June 2013 in our hospital were retrospectively analyzed, the intra-abdominal pressure measurement range and inflammatory markers as well as important changes in organ function changes relationships were analyzed; and the patients＇ complications after the situation after early treatment and patients＇ mortality were observed. Result With gradually increased intra-abdominal pressure measurement range, the inflammatory marker levels of red blood cells, white blood cells, CRP and so gradually increased, blood pressure, oxygen saturation, renal plasma flow, glomerular filtration rate, urine and other important dirty 24 hours function level decreased, the difference was statistically significant（P〈0.05）; among 42 cases of patients, 8 cases with renal failure, 5 cases with heart failure, 3 cases with concurrent Ⅱ respiratory failure, 1 case with DIC, early diagnosis and aggressive treatment were given to these patients based on the sustained abdominal pressure monitoring value, and 32 cases were ultimately cured, the cure rate was 76.2%; 10 cases were failure and died due to multiple organ, the mortality rate was 23.8%. Conclusion Early diagnosis of persistent abdominal pressure monitoring can effectively guide the abdominal injury caused by abdominal compartment syndrome instructive significance, thereby reducing mortality.