CAJ | 학술논문

目的探讨腹腔置管减压治疗恶性腹水源性腹腔间隔室综合征(ACS)的临床效果.方法对2002年10月至2008年10月收治的29例恶性腹水源性ACS病例资料进行回顾性分析.通过腹腔置管进行腹腔减压,观察腹腔减压过程中腹腔压力与腹水减压量的变化趋势,监测减压过程中及减压后24 h生命体征及减压前后24 h尿量变化.结果腹内压(IAP)小于25 cm H2O者2例,25～35 cm H2O者21例,大于35 cm H2O者6例.全组患者在腹水排出1000～1500 ml时LAP下降明显.其后lAP曲线逐渐变缓,腹水排空后IAP维持在11～12 cm H2O,在24 h后降至6～8 cm H2O.与腹腔减压前比较,血压始终维持稳定,前后差异无统计学意义(P>0.05);但呼吸频率和心率均较腹腔减压前明显变缓,尿量明显增多,差异有统计学意义(均P<0.01).结论恶性腹水源性ACS早期腹腔置管减压可改善心、肺和肾功能.
목적 탐토복강치관감압치료악성복수원성복강간격실종합정(ACS)적림상효과.방법 대2002년10월지2008년10월수치적29례악성복수원성ACS병례자료진행회고성분석.통과복강치관진행복강감압,관찰복강감압과정중복강압력여복수감압량적변화추세,감측감압과정중급감압후24 h생명체정급감압전후24 h뇨량변화.결과 복내압(IAP)소우25 cm H2O자2례,25～35 cm H2O자21례,대우35 cm H2O자6례.전조환자재복수배출1000～1500 ml시LAP하강명현.기후lAP곡선축점변완,복수배공후IAP유지재11～12 cm H2O,재24 h후강지6～8 cm H2O.여복강감압전비교,혈압시종유지은정,전후차이무통계학의의(P>0.05);단호흡빈솔화심솔균교복강감압전명현변완,뇨량명현증다,차이유통계학의의(균P<0.01).결론 악성복수원성ACS조기복강치관감압가개선심、폐화신공능.
Objective To investigate the efficacy of pressure reduction by peritoneal catheterization in patients with malignant ascites-induced abdominal compartment syndrome(ACS).Methods Clinical data of 29 patients with malignant ascites-induced ACS from October 2002 to October 2008 were analyzed retrospectively.Intra-abdominal pressure(lAP)was reduced by peritoneal catheterization.Changes of intra-abdominal pressure and ascites volume were observed during treatment.Clinical signsand urinary volume were monitored.Results IAP was less than 25 cm H2O in 2 cases,25 to 35 cm H2O in 21 cases,more than 35 cm H2O in 6 cases.IAP decreased significantly after drainage of 1000 to 1500 ml of ascites,then IAP curve leveled off.With all the aseites drained,IAP maintained at 11 to 12 cm H2O and at 6 to 8 cm H2O after 24 hours.Blood pressure was stable without significant changes before and after IAP reduction(P>0.05).The breathing rate and heart rate were improved,and 24 h urinary volume increased significantly after IAP reduction(P<0.01).Conclusion Early peritoneal catbeterization can improve the cardiac,pulmonary,and renal function in malignant ascites-induced ACS.