小肠减压在危重患者腹腔高压中的应用

Application of small intestinal decompression for abdominal hypertension in critically ill patients

目的探讨经鼻小肠减压治疗对危重患者腹腔高压(IAH)的改善效果。方法选择2013年8月-2015年8月海军总医院重症医学科收治的IAH患者14例,在X线下经鼻置入小肠减压管,记录患者减压前后心率、平均动脉压、呼吸频率、腹围、尿素氮、肌酐、尿量、乳酸、减压后24h腹内压等指标。结果小肠减压后所有患者的心率、呼吸频率、腹围、腹内压均较减压前明显下降(P<0.01);减压后尿量明显增多,乳酸明显下降(P<0.01),但平均动脉压在减压前后无明显变化(P>0.05),尿素氮、肌酐等减压前后亦无明显变化(P>0.05)。结论经鼻小肠减压用于腹腔高压患者早期非手术减压安全有效。

Objective To investigate the effect of the small intestinal decompression on intra-abdominal hypertension（IAH） in critically ill patients.Methods Fourteen IAH patients received small intestinal decompression under the X ray in Navy General Hospital of PLA from August 2013 to August 2015,and the heart rate,mean arterial pressure,breathing rate,abdominal perimeter,urea nitrogen,creatinine,urine output per hour,24-h intra-abdominal pressure after decompression,and lactic acid before and after the decompression were examined and recorded.Results After decompression all the patients＇ heart rate,breathing rate,abdominal perimeter,intra-abdominal pressure significantly decreased（P〈0.01）.Urine volume per hour increased significantly after decompression,lactic acid decreased obviously（P〈0.01）.But the mean arterial pressure,urea nitrogen and creatinine had no obvious change after the decompression（P〉0.05）.Conclusion Transnasal small intestinal decompression is safe and effective for the critically ill patients with intra-abdominal hypertension.