岭南现代临床外科
嶺南現代臨床外科
령남현대림상외과
LINGNAN MODERN CLINICS IN SURGERY
2014年
3期
345-348
,共4页
腹内压%腹腔灌注压%体位
腹內壓%腹腔灌註壓%體位
복내압%복강관주압%체위
Intra abdominal hypertension%Body position%Abdominal perfusion pressure
目的：观察不同体位对腹内压及腹腔灌注压的影响。方法对2013年1月～2013年12月收治ICU的有腹内压监测适应征的78位患者分别在0°、15°、30°、45°采用测量膀胱压的方法监测腹内压，并计算腹腔灌注压。结果在腹内高压者，30°（21．46±3．91 mmHg， P＝0．001）及45°（25．69±4．09 mmHg， P＜0．001）时腹内压比0°（16．31±3．38 mmHg）时明显升高，而腹腔灌注压45°（51．92±10．05 mmHg，P＝0．03）时明显低于0°（60．54±9．86 mmHg）；在腹内压正常者30°（11．17±3．24 mmHg，P＝0．002）及45°（15．59±4．13 mmHg， P＝0．001）时腹内压比0°（7．23±2．14 mmHg）时明显升高，而腹腔灌注压45°（60．78±9．13 mmHg， P＝0．004）时明显低于0°（71．28±8．86 mmHg）。结论危重病人不同体位对腹内压及腹腔灌注压有影响，床头角度越高，腹内压越高，腹腔灌注压越低，提示测量时应考虑体位的因素。
目的：觀察不同體位對腹內壓及腹腔灌註壓的影響。方法對2013年1月～2013年12月收治ICU的有腹內壓鑑測適應徵的78位患者分彆在0°、15°、30°、45°採用測量膀胱壓的方法鑑測腹內壓，併計算腹腔灌註壓。結果在腹內高壓者，30°（21．46±3．91 mmHg， P＝0．001）及45°（25．69±4．09 mmHg， P＜0．001）時腹內壓比0°（16．31±3．38 mmHg）時明顯升高，而腹腔灌註壓45°（51．92±10．05 mmHg，P＝0．03）時明顯低于0°（60．54±9．86 mmHg）；在腹內壓正常者30°（11．17±3．24 mmHg，P＝0．002）及45°（15．59±4．13 mmHg， P＝0．001）時腹內壓比0°（7．23±2．14 mmHg）時明顯升高，而腹腔灌註壓45°（60．78±9．13 mmHg， P＝0．004）時明顯低于0°（71．28±8．86 mmHg）。結論危重病人不同體位對腹內壓及腹腔灌註壓有影響，床頭角度越高，腹內壓越高，腹腔灌註壓越低，提示測量時應攷慮體位的因素。
목적：관찰불동체위대복내압급복강관주압적영향。방법대2013년1월～2013년12월수치ICU적유복내압감측괄응정적78위환자분별재0°、15°、30°、45°채용측량방광압적방법감측복내압，병계산복강관주압。결과재복내고압자，30°（21．46±3．91 mmHg， P＝0．001）급45°（25．69±4．09 mmHg， P＜0．001）시복내압비0°（16．31±3．38 mmHg）시명현승고，이복강관주압45°（51．92±10．05 mmHg，P＝0．03）시명현저우0°（60．54±9．86 mmHg）；재복내압정상자30°（11．17±3．24 mmHg，P＝0．002）급45°（15．59±4．13 mmHg， P＝0．001）시복내압비0°（7．23±2．14 mmHg）시명현승고，이복강관주압45°（60．78±9．13 mmHg， P＝0．004）시명현저우0°（71．28±8．86 mmHg）。결론위중병인불동체위대복내압급복강관주압유영향，상두각도월고，복내압월고，복강관주압월저，제시측량시응고필체위적인소。
Objective To observe the effects of body positioning on intra-abdominal hypertension (IAP) and abdominal perfusion pressure (APP) in critically ill patients. Methods We investigated 78 patients admitted to ICU and measured their IAP from January 2013 to December 2013. IAP was measured with the patient head of bed (HOB) increases from 0° , 15° , 30° to 45° via the bladder. APP was also calculated simultaneously. Results In the patients with high IAP, compared with IAP at supine position (bed of head=0° ,16.31 ±3.38 mmHg), it showed significant difference at 30° (21.46±3.91 mmHg, P=0.001) and 45° (25.69±4.09 mmHg, P<0.001). And APP had significantly decreased at 45°(51.92±10.05 mmHg, P=0.03) when compared with that at supine position (60.54± 9.86 mmHg). In the patients of normal IAP, compared with IAP at supine position (bed of head=0°, 7.23±2.14 mmHg), it showed significant difference at 30° (11.17±3.24 mmHg,P=0.002) and 45° (15.59±4.13 mmHg,P=0.001). And APP had significantly decreased at 45° (60.78±9.13 mmHg, P=0.004) when compared with that at supine position (71.28 ±8.86 mmHg). Conclusion Body positioning had effects on IAP and APP, IAP significantly increased and APP decreased when the patient's HOB was elevated. The potential contribution of body position in elevating IAP should be considered in critically ill patients.
