腹内压值对外科急腹症患者的检测价值研究

The Detection Value of Abdominal Internal Pressure for Surgical Acute Abdomen Patients

目的:评估膀胱压力(BP)测量作为急腹症诊断工具的临床价值。方法:选取在我院外科治疗的患者,根据病情分为两组:一组为325例急腹症患者,对照组为50例进行腹腔镜手术的患者。在治疗前测量患者腹内压力。患者采用仰卧位,将50 m L无菌生理盐水缓慢注射到膀胱中,待排光后检测BP。将导管同水压计连接,以耻骨联合处为参考点。将BP值大于10 cm H2O,作为诊断急腹症的标准。结果:BP诊断急腹症的灵敏度为94.4%,特异性为79%,阳性预测值为95.9%,阴性预测值为71.7%,精确度为92.3%。结论:腹内压(IAP)升高可以作为急性腹痛的诊断工具。BP检测有助于临床医生在试验室检查或影像学检查结果有限时对患者病情进行评估。

Objective： To evaluate the bladder pressure （BP） measurement as a diagnostic tool in clinic for acute abdominal pain. Methods： The subjects were patients treated in our hospital. According to the disease state, they were divided into two groups： one group included 325 patients with acute abdomen, and another group included 50 patients who got laparoscopic surgery, as the control group. The intra-abdominal pressure was measured before treatment. Patients adopted a supine position when they had 50ml sterile saline slowly injected into their bladder, and then had BP detection after the injection. The catheter was connected with the pressure meter, and pubic syrnphysis as reference point. The level of BP larger than 10 cm H2O was taken as the standard of diagnosis of acute abdomen. Results： In diagnosis of acute abdomen, the sensitivity of BP was 94.4%, and the specificity was 79%; the positive predictive value was 95.9%, while the negative predictive value was 71.7%; the accuracy was 92.3%. Conclusion： We found that the increase of IAP can be used as a diagnostic tool for acute abdominal pain. Detection of BP is conducive for clinicians to evaluate the disease state of patient when laboratory tests or imaging examination results were limited.