东南国防医药
東南國防醫藥
동남국방의약
JOURNAL OF SOUTHEAST CHINA NATIONAL DEFENCE MEDICAL SCIENCE
2014年
3期
246-248
,共3页
腹内压变化率%腹腔内高压症%预后%APACHE Ⅱ评分
腹內壓變化率%腹腔內高壓癥%預後%APACHE Ⅱ評分
복내압변화솔%복강내고압증%예후%APACHE Ⅱ평분
change rate of intra-abdominal pressure%intra-abdominal hypertension%prognosis%APACHE Ⅱscore
目的：探讨腹内压变化率在评价腹腔内高压症（ intra-abdominal hypertension ，IAH）患者病情及预后的价值。方法采用经膀胱测压法监测85例IAH患者腹内压（intra-abdominal pressure，IAP），将（第3天平均腹内压-第1天平均腹内压）／第1天平均腹内压×100％的值定为腹内压变化率。检测患者血清C反应蛋白（ CRP）水平，并计算急性生理及慢性健康状况评分系统评分（ acute physiology and chronic health evaluation Ⅱ，APACHEⅡ）及病死率。结果入住重症监护病房（ ICU）第1天时，腹内压变化率≤50％与＞50％的患者APACHE Ⅱ评分及CRP水平比较无显著性差异（P＞0．05），而在第3天时，腹内压变化率≤50％患者APACHE Ⅱ评分及CRP水平分别为（23．83±5．71）分和（197．01±32．05）mg／L，均显著低于腹内压变化率＞50％的患者[（35．29±6．28）分和（346．35±60．18）mg／L]，差异均有统计学意义（P＜0．05）。腹内压变化率与第3天APACHE Ⅱ评分及CRP水平呈显著正相关（APACHE Ⅱ：r＝0．714，P＜0．01；CRP：r＝0．835，P＜0．01）。腹内压变化率在死亡组与存活组间存在显著差异（P＜0．01）。经ROC曲线分析，腹内压变异率对于预测患者死亡率有意义（AUC＝0．830，P＜0．01）。结论腹内压变化率可反映IAH患者的病情和预后，有望为IAH患者的早期干预治疗提供依据。
目的：探討腹內壓變化率在評價腹腔內高壓癥（ intra-abdominal hypertension ，IAH）患者病情及預後的價值。方法採用經膀胱測壓法鑑測85例IAH患者腹內壓（intra-abdominal pressure，IAP），將（第3天平均腹內壓-第1天平均腹內壓）／第1天平均腹內壓×100％的值定為腹內壓變化率。檢測患者血清C反應蛋白（ CRP）水平，併計算急性生理及慢性健康狀況評分繫統評分（ acute physiology and chronic health evaluation Ⅱ，APACHEⅡ）及病死率。結果入住重癥鑑護病房（ ICU）第1天時，腹內壓變化率≤50％與＞50％的患者APACHE Ⅱ評分及CRP水平比較無顯著性差異（P＞0．05），而在第3天時，腹內壓變化率≤50％患者APACHE Ⅱ評分及CRP水平分彆為（23．83±5．71）分和（197．01±32．05）mg／L，均顯著低于腹內壓變化率＞50％的患者[（35．29±6．28）分和（346．35±60．18）mg／L]，差異均有統計學意義（P＜0．05）。腹內壓變化率與第3天APACHE Ⅱ評分及CRP水平呈顯著正相關（APACHE Ⅱ：r＝0．714，P＜0．01；CRP：r＝0．835，P＜0．01）。腹內壓變化率在死亡組與存活組間存在顯著差異（P＜0．01）。經ROC麯線分析，腹內壓變異率對于預測患者死亡率有意義（AUC＝0．830，P＜0．01）。結論腹內壓變化率可反映IAH患者的病情和預後，有望為IAH患者的早期榦預治療提供依據。
목적：탐토복내압변화솔재평개복강내고압증（ intra-abdominal hypertension ，IAH）환자병정급예후적개치。방법채용경방광측압법감측85례IAH환자복내압（intra-abdominal pressure，IAP），장（제3천평균복내압-제1천평균복내압）／제1천평균복내압×100％적치정위복내압변화솔。검측환자혈청C반응단백（ CRP）수평，병계산급성생리급만성건강상황평분계통평분（ acute physiology and chronic health evaluation Ⅱ，APACHEⅡ）급병사솔。결과입주중증감호병방（ ICU）제1천시，복내압변화솔≤50％여＞50％적환자APACHE Ⅱ평분급CRP수평비교무현저성차이（P＞0．05），이재제3천시，복내압변화솔≤50％환자APACHE Ⅱ평분급CRP수평분별위（23．83±5．71）분화（197．01±32．05）mg／L，균현저저우복내압변화솔＞50％적환자[（35．29±6．28）분화（346．35±60．18）mg／L]，차이균유통계학의의（P＜0．05）。복내압변화솔여제3천APACHE Ⅱ평분급CRP수평정현저정상관（APACHE Ⅱ：r＝0．714，P＜0．01；CRP：r＝0．835，P＜0．01）。복내압변화솔재사망조여존활조간존재현저차이（P＜0．01）。경ROC곡선분석，복내압변이솔대우예측환자사망솔유의의（AUC＝0．830，P＜0．01）。결론복내압변화솔가반영IAH환자적병정화예후，유망위IAH환자적조기간예치료제공의거。
Objective To explore the value of the change rate of IAP in evaluating for the condition and prognosis in IAH pa -tients.Methods IAP was indirectly measured by urinary bladder pressure for 85 IAH patients,and the value of [(3 day average IAP-1 day average IAP )/1 day average IAP ×100%] was regarded as change rate of IAP .The serum CRP level was detected ,and the A-PACHE II,SOFA score and mortality were calculated .Results On the first day of ICU ,the APACHEⅡscore and serum CRP level of patients of change rate of IAP≤50% and >50% were similar (P>0.05).But on the third day,the APACHE Ⅱ score and serum CRP level were (23.83 ±5.71) points and (197.01 ±32.05) mg/L in ≤50% group respectively,and (35.29 ±6.28) points and (346.35 ±60.18) mg/L in >50%group respectively.There were significant difference between the two groups (P<0.05).And the change rate of intra-abdominal pressure was significantly positively related to the 3 d APACHE Ⅱ score and c-reactive protein ( A-PACHE Ⅱ:r=0.714,P<0.01;CRP:r=0.835,P<0.01).There were significant differences in change rate of intra-abdominal pres-sure between the death group and alive group (P<0.01).Analysis of the ROC curve showed that there was a significant meaning of the change rate of intra-abdominal pressure for diagnosis of mortality (AUC=0.830,P<0.01).Conclusion Change rate of IAP can ef-fectively reflect the condition and prognosis of IAH patients ,and is expected to provide theoretical basis for IAH patients early interven-tion treatment .
