腹内高压与急性胰腺炎严重程度的相关性分析

Correlation between IAH and the severity of acute pancreatitis

目的探讨腹内高压(intra-abdominal hypertension,IAH)与急性胰腺炎(acutepancreatitis,AP)疾病严重程度的相关性,为临床诊治提供参考。方法选择AP患者58例,根据APACHEⅡ评分分为轻症急性胰腺炎(minor acute pancreatitis,MAP)组和重症急性胰腺炎(severe acut epancreatitis,SAP)组。监测腹内压(intra-abdominal pressure,IAP),比较两组IAH发生率,分析APACHEⅡ评分与IAP相关性;统计两组患者住院时间、并发症发生率、病死率等临床指标。将SAP组患者分为IAH组和非IAH组,比较两组临床指标情况。结果 MAP组患者IAH发生率为0.00%,SAP组患者IAH发生率为65.22%,差异有统计学意义(P<0.01)。两组住院时间、并发症发生率及病死率比较,差异有统计学意义(P<0.01)。SAP患者IAP与APACHEⅡ评分明显相关(r=0.769,P=0.043)。结论 IAH显著影响AP患者严重程度,SAP患者APACHEⅡ评分与IAP明显相关,SAP患者应全程监测IAP,做到早期发现与治疗,控制腹腔压力,有利于改善MAP情况、状态及脏器功能。

Objective To investigate the correlation between intra-abdominal hypertension（ IAH） and the severrity of acute pancreatitis（ AP）. Methods Fifty-eight patients with acute pancreatitis were divided into the mild acute pancreatitis（ MAP） group and the severe acute pancreatitis（ SAP） group. The intra-abdominal pressure（ IAP）were compared between the two groups and the correlation between APACHEⅡ scores and IAP was analyzed. The hospital stay,morbidity,and mortality incidence of complications were compared between the two groups. The patients of SAP group were divided into two subgroups： IAH subgroup and non-SAP IAH subgroup,and their clinical data were comparad. Results The incidence of IAH was 0. 00% in MAP group,and 65. 22% in SAP group,with a significant difference（ P〈0. 01）. There were significant differences in the hospital stay,incidence of complications and mortality between MAP group and SAP group（ P〈0. 01）. In SAP patients,there was a correlation between IAP and APACHEⅡscores. Conclusion IAH significantly affects the severity of AP,and SAP patients should be monitored by IAP,for early diagnosis and treatment.