疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
9期
913-915
,共3页
腹内压变异率%重症胰腺炎%病情%预后
腹內壓變異率%重癥胰腺炎%病情%預後
복내압변이솔%중증이선염%병정%예후
Intra-abdominal pressure variation rate%Severe pancreatitis%Illness%Prognosis
目的：探讨腹内压变异率与重症胰腺炎病情严重程度和临床预后的关系。方法选取重症胰腺炎患者79例，均每天采用间接膀胱内压测量法监测腹内压（IAP），根据急性生理学与慢性健康状况评分（APACHEII）进行分组，其中APACHEII≥15分（中位值）为观察组40例，APACHEII＜15分为对照组39例，比较2组患者腹内压水平、Ranson评分结果，分析腹内压变异率、APACHEII、Ranson 评分和临床预后的关系。结果观察组腹内压峰值、Ranson评分、器官功能不全发生率和病死率均明显高于对照组（ P ＜0 j．05）；经Pearson相关性分析，腹内压变异率与APACHEII评分、Ranson评分呈明显的正相关（ r ＝0．872，0．718， P ＜0．05），APACHEII与Ranson评分呈明显的正相关（ r ＝0．694， P ＜0．05）；腹内压变异率对病死率预测值（ ROC曲线下面积）为93．65％，稍高于APACHEII评分的89．65％，两者比较差异无统计学意义（ P ＞0．05），而与Ranson评分预测值82．24％比较差异具有统计学意义（ P ＜0．05）。结论腹内压变异率越高，重症胰腺炎病情越严重，且临床预后越差。
目的：探討腹內壓變異率與重癥胰腺炎病情嚴重程度和臨床預後的關繫。方法選取重癥胰腺炎患者79例，均每天採用間接膀胱內壓測量法鑑測腹內壓（IAP），根據急性生理學與慢性健康狀況評分（APACHEII）進行分組，其中APACHEII≥15分（中位值）為觀察組40例，APACHEII＜15分為對照組39例，比較2組患者腹內壓水平、Ranson評分結果，分析腹內壓變異率、APACHEII、Ranson 評分和臨床預後的關繫。結果觀察組腹內壓峰值、Ranson評分、器官功能不全髮生率和病死率均明顯高于對照組（ P ＜0 j．05）；經Pearson相關性分析，腹內壓變異率與APACHEII評分、Ranson評分呈明顯的正相關（ r ＝0．872，0．718， P ＜0．05），APACHEII與Ranson評分呈明顯的正相關（ r ＝0．694， P ＜0．05）；腹內壓變異率對病死率預測值（ ROC麯線下麵積）為93．65％，稍高于APACHEII評分的89．65％，兩者比較差異無統計學意義（ P ＞0．05），而與Ranson評分預測值82．24％比較差異具有統計學意義（ P ＜0．05）。結論腹內壓變異率越高，重癥胰腺炎病情越嚴重，且臨床預後越差。
목적：탐토복내압변이솔여중증이선염병정엄중정도화림상예후적관계。방법선취중증이선염환자79례，균매천채용간접방광내압측량법감측복내압（IAP），근거급성생이학여만성건강상황평분（APACHEII）진행분조，기중APACHEII≥15분（중위치）위관찰조40례，APACHEII＜15분위대조조39례，비교2조환자복내압수평、Ranson평분결과，분석복내압변이솔、APACHEII、Ranson 평분화림상예후적관계。결과관찰조복내압봉치、Ranson평분、기관공능불전발생솔화병사솔균명현고우대조조（ P ＜0 j．05）；경Pearson상관성분석，복내압변이솔여APACHEII평분、Ranson평분정명현적정상관（ r ＝0．872，0．718， P ＜0．05），APACHEII여Ranson평분정명현적정상관（ r ＝0．694， P ＜0．05）；복내압변이솔대병사솔예측치（ ROC곡선하면적）위93．65％，초고우APACHEII평분적89．65％，량자비교차이무통계학의의（ P ＞0．05），이여Ranson평분예측치82．24％비교차이구유통계학의의（ P ＜0．05）。결론복내압변이솔월고，중증이선염병정월엄중，차림상예후월차。
Objective To explore the relationship among intra-abdominal pressure variation rate and severe pancreati-tis severity and clinical prognosis .Methods Selected 79 cases of patients with severe pancreatitis , intra-abdominal pressure ( IAP) were measured by indirect monitoring bladder pressure measurement , according to the score of acute physiology and chronic health evaluation (APACHEII), APACHEII ≥15 (median) were defined as the observation group with 40 cases, APACHEII<15 as the control group with 39 cases, intra-abdominal pressure level , Ranson score results were compared be-tween the 2 groups of patients , analyzed the relationship between intra-abdominal pressure variation rate , APACHEII, Ranson score and clinical prognosis .Results Intra-abdominal pressure peak value , Ranson score and organ dysfunction and mortality of observation group were significantly higher than those in the control group ( P <0.05);the Pearson correlation analysis re-vealed that intra-abdominal pressure variation rate was significantly and positively related to APACHEII score and Ranson score ( R =0.872, R =0.718, P <0.05), APACHEII was significantly and positively related to and Ranson score ( R =0.694, P <0.05);intra-abdominal pressure variation rate predictive value for mortality (area under the ROC curve) was 93.65%, slightly higher than the APACHEII score of 89.65%, no statistically significant difference between them were found ( P >0.05), and Ranson score’s predicting value was 82.24%, there were significant difference between intra-abdominal pressure variation rate and Ranson score ( P <0.05).Conclusion Along with intra-abdominal pressure variation rate increased , se-vere pancreatitis is more serious , and the prognosis gets worse .
