BACKGROUND: Noninvasive monitoring of intra-abdominal pressure(IAP) by measuring abdominal wall tension(AWT) was effective and feasible in previous postmortem and animal studies. This study aimed to investigate the fe...BACKGROUND: Noninvasive monitoring of intra-abdominal pressure(IAP) by measuring abdominal wall tension(AWT) was effective and feasible in previous postmortem and animal studies. This study aimed to investigate the feasibility of the AWT method for noninvasively monitoring IAP in the intensive care unit(ICU).METHODS: In this prospective study, we observed patients with detained urethral catheters in the ICU of Shanghai Tenth People's Hospital between April 2011 and March 2013. The correlation between AWT and urinary bladder pressure(UBP) was analyzed by linear regression analysis. The effects of respiratory and body position on AWT were evaluated using the paired samples t test, whereas the effects of gender and body mass index(BMI) on baseline AWT(IAP<12 mm Hg) were assessed using one-way analysis of variance.RESULTS: A total of 51 patients were studied. A significant linear correlation was observed between AWT and UBP(R=0.986, P<0.01); the regression equation was Y=–1.369+9.57X(P<0.01). There were signif icant differences among the different respiratory phases and body positions(P<0.01). However, gender and BMI had no signif icant effects on baseline AWT(P=0.457 and 0.313, respectively).CONCLUSIONS: There was a signif icant linear correlation between AWT and UBP and respiratory phase, whereas body position had signif icant effects on AWT but gender and BMI did not. Therefore, AWT could serve as a simple, rapid, accurate, and important method to monitor IAP in critically ill patients.展开更多
探究基于“-TT”结构经监护仪腹内压监测法降低重症患者喂养不耐受发生率的效果。选取2022年8月—2023年8月四川省自贡市第四人民医院抢救监护室(emergency intensive care unit,EICU)60例重症需行肠内营养(enteral nutrition,EN)支持...探究基于“-TT”结构经监护仪腹内压监测法降低重症患者喂养不耐受发生率的效果。选取2022年8月—2023年8月四川省自贡市第四人民医院抢救监护室(emergency intensive care unit,EICU)60例重症需行肠内营养(enteral nutrition,EN)支持的患者作为研究对象,采用随机数字表法将患者分为参照组和试验组,每组各30例。参照组实施常规EN管理,试验组在参照组基础上实施基于“-TT”结构经监护仪腹内压监测法,对比两组患者的喂养不耐受发生率。结果显示,与参照组相比,试验组喂养不耐受发生率较低(P<0.05);试验组达到目标喂养量时间较短(P<0.05);试验组EICU停留时间较短(P<0.05)。研究发现,于EICU重症需行EN支持患者的管理中,基于“-TT”结构经监护仪腹内压监测法具有一定的临床应用价值,通过对患者腹压变化的实时监测,可以及时调整喂养方案,降低其喂养不耐受发生率,缩短患者达到目标喂养量的时间,改善患者预后,值得借鉴。展开更多
目的探讨腹内压(Intra-abdominal pressure,IAP)联合胃残余量监测在重症监护病房(intensive care unit,ICU)患者早期肠内营养耐受性观察中的作用。方法分析2013年186例入住ICU并且实施肠内营养的危重患者,随机分成试验组和对照组各93例...目的探讨腹内压(Intra-abdominal pressure,IAP)联合胃残余量监测在重症监护病房(intensive care unit,ICU)患者早期肠内营养耐受性观察中的作用。方法分析2013年186例入住ICU并且实施肠内营养的危重患者,随机分成试验组和对照组各93例。分别采用腹内压联合胃残余量监测方案和常规护理措施。比较两组腹胀、呕吐、腹泻的发生率和目标喂养量的达标率。结果试验组腹胀的发生率为26.88%,对照组腹胀的发生率为55.91%(P<0.01),差异有显著统计学意义;试验组呕吐的发生率为9.68%,对照组呕吐的发生率为21.50%(P<0.05),差异有统计学意义;试验组腹泻的发生率为8.60%,对照组腹泻的发生率为10.75%(P>0.05),差异无统计学意义;两组患者均达到目标喂养量,试验组目标喂养量达标率为88.17%,对照组目标喂养量达标率为86.02%,差异无统计学意义。结论腹内压联合胃残余量监测方案可以有效降低ICU患者早期肠内营养腹胀、呕吐的发生率,使其早日达到目标喂养量,对于提高患者早期肠内营养耐受性有重要意义。展开更多
基金supported by a grant from Shanghai Municipal Health Bureau Program(2009143)
文摘BACKGROUND: Noninvasive monitoring of intra-abdominal pressure(IAP) by measuring abdominal wall tension(AWT) was effective and feasible in previous postmortem and animal studies. This study aimed to investigate the feasibility of the AWT method for noninvasively monitoring IAP in the intensive care unit(ICU).METHODS: In this prospective study, we observed patients with detained urethral catheters in the ICU of Shanghai Tenth People's Hospital between April 2011 and March 2013. The correlation between AWT and urinary bladder pressure(UBP) was analyzed by linear regression analysis. The effects of respiratory and body position on AWT were evaluated using the paired samples t test, whereas the effects of gender and body mass index(BMI) on baseline AWT(IAP<12 mm Hg) were assessed using one-way analysis of variance.RESULTS: A total of 51 patients were studied. A significant linear correlation was observed between AWT and UBP(R=0.986, P<0.01); the regression equation was Y=–1.369+9.57X(P<0.01). There were signif icant differences among the different respiratory phases and body positions(P<0.01). However, gender and BMI had no signif icant effects on baseline AWT(P=0.457 and 0.313, respectively).CONCLUSIONS: There was a signif icant linear correlation between AWT and UBP and respiratory phase, whereas body position had signif icant effects on AWT but gender and BMI did not. Therefore, AWT could serve as a simple, rapid, accurate, and important method to monitor IAP in critically ill patients.
文摘探究基于“-TT”结构经监护仪腹内压监测法降低重症患者喂养不耐受发生率的效果。选取2022年8月—2023年8月四川省自贡市第四人民医院抢救监护室(emergency intensive care unit,EICU)60例重症需行肠内营养(enteral nutrition,EN)支持的患者作为研究对象,采用随机数字表法将患者分为参照组和试验组,每组各30例。参照组实施常规EN管理,试验组在参照组基础上实施基于“-TT”结构经监护仪腹内压监测法,对比两组患者的喂养不耐受发生率。结果显示,与参照组相比,试验组喂养不耐受发生率较低(P<0.05);试验组达到目标喂养量时间较短(P<0.05);试验组EICU停留时间较短(P<0.05)。研究发现,于EICU重症需行EN支持患者的管理中,基于“-TT”结构经监护仪腹内压监测法具有一定的临床应用价值,通过对患者腹压变化的实时监测,可以及时调整喂养方案,降低其喂养不耐受发生率,缩短患者达到目标喂养量的时间,改善患者预后,值得借鉴。
文摘目的探讨腹内压(Intra-abdominal pressure,IAP)联合胃残余量监测在重症监护病房(intensive care unit,ICU)患者早期肠内营养耐受性观察中的作用。方法分析2013年186例入住ICU并且实施肠内营养的危重患者,随机分成试验组和对照组各93例。分别采用腹内压联合胃残余量监测方案和常规护理措施。比较两组腹胀、呕吐、腹泻的发生率和目标喂养量的达标率。结果试验组腹胀的发生率为26.88%,对照组腹胀的发生率为55.91%(P<0.01),差异有显著统计学意义;试验组呕吐的发生率为9.68%,对照组呕吐的发生率为21.50%(P<0.05),差异有统计学意义;试验组腹泻的发生率为8.60%,对照组腹泻的发生率为10.75%(P>0.05),差异无统计学意义;两组患者均达到目标喂养量,试验组目标喂养量达标率为88.17%,对照组目标喂养量达标率为86.02%,差异无统计学意义。结论腹内压联合胃残余量监测方案可以有效降低ICU患者早期肠内营养腹胀、呕吐的发生率,使其早日达到目标喂养量,对于提高患者早期肠内营养耐受性有重要意义。