不同水平腹内压对肾功能影响的相关性研究

发布时间：2018-04-11 08:50

本文选题：腹内压 + 腹腔内高压　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的1.观察ICU患者不同水平腹内压（IAP）下肾功能的变化，分析二者的影响因素。2.探讨腹腔内高压（IAH）与急性肾功能衰竭（ARF）的关系。方法2011年1月至2013年1月广西医科大一附院ICU收治所有危重症患者，入科后即应用膀胱测压法监测腹内压，共133例。根据不同腹内压水平分成5组，非IAH组67例，I级组（IAP12-15mmHg）31例，II级组（16-20mmHg）15例，，III级组（21-25mmHg）17例，IV级组（IAP＞25mmHg）3例，所有患者均于入住ICU即日开始监测IAP，每6小时记录１次IAP。IAH出现24小时内，同时监测血肌酐、尿素氮、胱抑素C、24小时尿量、24小时输液量、平均动脉压。同时对患者入科24小时、首次出现腹内高压时和腹内压力最高时分别进行APACHEII、MODS、SOFA评分。对不同水平腹内压下患者的资料进行相关性分析。结果不同水平腹内压与肾功能、APACHEII评分、MODS评分呈相关性，腹腔内高压（IAH）与急性肾功能衰竭（ARF）呈相关性，不同水平腹内压下行CRRT、腹水穿刺引流，有助于肾功能的改善。结论应常规监测ICU患者的腹内压（IAP）变化，及早发现腹腔内高压（IAH），积极干预和治疗，如CRRT、腹水穿刺引流，有助于肾功能的改善、预防急性肾功能衰竭（ARF）的发生。
[Abstract]:Objective 1.To observe the changes of renal function in patients with ICU under different levels of intraabdominal pressure, and to analyze the influencing factors. 2. 2.To investigate the relationship between intraperitoneal hypertension (IAH) and acute renal failure (ARF).Methods from January 2011 to January 2013, all critically ill patients were treated in ICU of the first affiliated Hospital of Guangxi Medical University. After admission, intraabdominal pressure was monitored by bladder manometry in 133 cases.Blood creatinine, urea nitrogen and cystatin C were monitored 24 hours urine volume and 24 hours infusion volume, mean arterial pressure.At the same time, Apache II MODS sofa score was used for 24 hours, the first abdominal hypertension and the highest intraabdominal pressure.The data of patients with different levels of intraabdominal pressure were analyzed.Results different levels of intra-abdominal pressure were correlated with APACHEII score and mods score, intraperitoneal hypertension (IAH) was correlated with acute renal failure (ARF). CRRTand drainage of ascites under different levels of intra-abdominal pressure were helpful to the improvement of renal function.Conclusion it is necessary to routinely monitor the changes of intraabdominal pressure (ICU) in patients with ICU, to detect intraperitoneal hypertension early, and to intervene and treat actively, such as CRRT, drainage of ascites, which is helpful to improve renal function and prevent the occurrence of acute renal failure (ARF).
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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