体位对经膀胱内途径间接测定腹内压的影响研究

Research on effect of body position on the indirect measurement of intra-abdominal pressure by intravesical approach

目的探讨不同体位对经膀胱内途径间接测定腹内压的影响。方法择取2017年1月~2018年12月期间我院重症监护室收治的68例腹压增高症患者为研究对象,根据患者腹腔内压力(IAP)值分为不同级别腹压症状患者,包括Ⅰ级16例,Ⅱ级26例,Ⅲ级16例,Ⅳ级10例,四组患者分别处平卧位、15°半坐卧位、30°半坐卧位、45°半坐卧位、侧卧位及中凹位时经膀胱内途径间接检测腹内压数值,并进行比较,同时应用多因素线性回归分析法探究腹内压测量的影响因素。结果患者IAP分级越高腹内压测量结果越高,同时当患者处于45°半坐卧位时期腹内压测量结果最高,并与其他体位的测量结果差异之间存在统计学意义(P<0.05)。多因素线性回归分析法结果显示,性别、体重和机械通气是影响患者IAP测量的影响因素,其与患者IAP数据呈正相关(P<0.05)。结论体位改变为经膀胱内途径间接测量腹内压结果有一定影响性,因此进行腹内压检测时需要对患者的情况进行了解,选择合适的体位进行腹内压检测以保证检测结果准确性。

Objective To explore the effect of different body positions on the indirect measurement of intraabdominal pressure by intravesical approach.Methods Sixty-eight patients with abdominal hypertension who were admitted to the intensive care unit of our hospital from January 2017 to December 2018 were selected as research objects.According to the patients’intra-abdominal pressure(IAP)value,they were divided into different levels of abdominal pressure symptoms,including 16 cases of gradeⅠ,26 cases of gradeⅡ16 cases of gradeⅢ,10 cases of gradeⅣ.Intra-abdominal pressure values of patients in four groups were measured by intravesical approach in the supine position,15°semi-sitting position,30°semi-sitting position,45°semi-sitting position,lateral position and concave position and the values were compared.At the same time,multi-factor linear regression analysis was used to explore the influencing factors of intra-abdominal pressure measurement.Results The higher the IAP grade,the higher the intra-abdominal pressure measurement.At the same time,when the patient was in the 45°semi-sitting position,the measurement of intra-abdominal pressure was the highest,and there was statistical significance between the measurement results and other body position measurements(P<0.05).Multivariate linear regression analysis showed that gender,weight and mechanical ventilation were the influencing factors affecting IAP measurement in patients,which was positively correlated with IAP data of patients(P<0.05).Conclusion The change of body position has a certain effect on the indirect measurement of intra-abdominal pressure by intravesical approach.Therefore,it is necessary to understand the patients’condition when performing intra-abdominal pressure test and select the appropriate position for intra-abdominal pressure test to ensure the accuracy of the test results.