液体复苏量与急性重症胰腺炎患者腹内高压及肾脏损害的关系

发布时间：2018-04-13 09:14

本文选题：腹腔间隔室综合征 + 腹内高压　；参考：《第二军医大学学报》2015年10期

【摘要】：目的探讨液体复苏量与急性重症胰腺炎(SAP)腹内高压(IAH)及肾脏损害的关系。方法以60例SAP患者为研究对象,以AbViser法测量腹内压(IAP),根据IAP将研究对象分为正常组、IAH组和腹腔间隔室综合征(ACS)组,统计分析各组的一般情况、死亡率、液体复苏量及肾功能损害情况。结果 (1)本研究中IAH发病率为31.67%(19/60),ACS发病率为11.67%(7/60)。正常组、IAH组和ACS组死亡率分别为5.88%(2/34)、21.05%(4/19)和57.14%(4/7),ACS组死亡率高于正常组(P=0.007)。(2)正常组、IAH组和ACS组3日液体平衡量分别为(4 350±892)、(5 512±1 246)和(5 974±1 765)mL,组间比较差异有统计学意义(P0.001);总液体累积量分别为(8 530±2 384)、(9 403±2 064)、(13 172±2 409)mL,组间比较差异有统计学意义(P0.001)。其中ACS组3日液体平衡量及液体累积量均为最高。(3)正常组、IAH组和ACS组肾功能生化指标血肌酐、尿素氮组间差异均具有统计学意义(P0.001),ACS组血肌酐、尿素氮水平均高于正常组及IAH组(P0.05)。结论 SAP患者前3日液体累积量与IAH甚至ACS的发生密切相关,而IAH将进而导致SAP患者肾功能损伤。
[Abstract]:Objective to investigate the relationship between fluid resuscitation and intraabdominal hypertension (IAH) and renal damage in severe acute pancreatitis (SAP).Methods A total of 60 patients with SAP were enrolled in this study. The intraabdominal pressure was measured by AbViser method. According to IAP, the subjects were divided into normal group and celiac septal syndrome group. The general situation and mortality of each group were analyzed statistically.Fluid resuscitation volume and impairment of renal function.Results 1) in this study, the incidence of IAH was 31.67%, and the incidence of IAH was 11.67%.The volume of product was 9 403 卤2 064 mL. the difference between the two groups was statistically significant (P 0.001).The serum creatinine and urea nitrogen levels in ACS group were significantly higher than those in normal group and IAH group (P 0.05).Conclusion the accumulation of fluid in the first 3 days of SAP patients is closely related to the occurrence of IAH and even ACS, while IAH may lead to renal function damage in SAP patients.
【作者单位】：重庆医科大学附属第一医院重症医学科/外科ICU;
【基金】：重庆医科大学附属第一医院基金(HLJJ2014-11)~~
【分类号】：R576

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