中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2015年
16期
10-13,17
,共5页
腹腔内压%腹内高压%腹腔间隔室综合征%妊娠
腹腔內壓%腹內高壓%腹腔間隔室綜閤徵%妊娠
복강내압%복내고압%복강간격실종합정%임신
Intra-abdominal pressure%Intra-abdominal hypertension%Abdominal compartment syndrome%Pregnancy
目的：比较妊娠正常妇女在分娩前后的腹腔内压与血流动力学的变化差异。方法纳入2011年11月～2012年3月拟在广州医学院第三附属医院进行分娩的妊娠妇女24例进行研究，根据妊娠类别分为单胎妊娠组（20例）及双胎妊娠组（4例），于分娩前后使用膀胱内压方法监测其腹腔内压变化，并观察血压、腹腔灌注压及心率的变化。结果（1）单胎妊娠妇女分娩后的收缩压及舒张压依次为（118.05±10.12）mm Hg、（70.95±7.65）mm Hg，与分娩前比较无统计学意义（P＞0.05）；分娩后产妇的心率为（83.76±11.31）次/min，较分娩前的（95.29±14.11）次/min有显著下降，且分娩后腹腔灌注压较分娩前也有明显提升，前后比较差异有统计学意义（P＜0.01）；（2）分娩前单胎妊娠妇女的IAP波动范围为14.28～48.96mmHg，平均（35.13±8.81）mm Hg，腹内高压（IAP高于12mm Hg）率100%，分娩后IAP范围则为8.84～25.84mm Hg，平均（16.16±4.61mm Hg），腹内高压率为85.7%（18/21），分娩前后对比差异有统计学意义（P＜0.01）。（3）双胎妊娠妇女分娩前IAP为（38.25±10.18）mm Hg，均属于腹内高压；分娩后IAP则为（22.61±10.98）mm Hg，其中腹内高压者占75%（3/4）；分娩后IAP较分娩前下降明显（P＜0.01）。结论正常妇女妊娠晚期的IAP明显增高，分娩后IAP明显下降而腹腔灌注压明显增高，血流动力学保持不变。临床上需加大研究力度，以便更为准确地确定孕产妇的正常IAP范围，为高危IAH和ACS的有效防治提供参考依据。
目的：比較妊娠正常婦女在分娩前後的腹腔內壓與血流動力學的變化差異。方法納入2011年11月～2012年3月擬在廣州醫學院第三附屬醫院進行分娩的妊娠婦女24例進行研究，根據妊娠類彆分為單胎妊娠組（20例）及雙胎妊娠組（4例），于分娩前後使用膀胱內壓方法鑑測其腹腔內壓變化，併觀察血壓、腹腔灌註壓及心率的變化。結果（1）單胎妊娠婦女分娩後的收縮壓及舒張壓依次為（118.05±10.12）mm Hg、（70.95±7.65）mm Hg，與分娩前比較無統計學意義（P＞0.05）；分娩後產婦的心率為（83.76±11.31）次/min，較分娩前的（95.29±14.11）次/min有顯著下降，且分娩後腹腔灌註壓較分娩前也有明顯提升，前後比較差異有統計學意義（P＜0.01）；（2）分娩前單胎妊娠婦女的IAP波動範圍為14.28～48.96mmHg，平均（35.13±8.81）mm Hg，腹內高壓（IAP高于12mm Hg）率100%，分娩後IAP範圍則為8.84～25.84mm Hg，平均（16.16±4.61mm Hg），腹內高壓率為85.7%（18/21），分娩前後對比差異有統計學意義（P＜0.01）。（3）雙胎妊娠婦女分娩前IAP為（38.25±10.18）mm Hg，均屬于腹內高壓；分娩後IAP則為（22.61±10.98）mm Hg，其中腹內高壓者佔75%（3/4）；分娩後IAP較分娩前下降明顯（P＜0.01）。結論正常婦女妊娠晚期的IAP明顯增高，分娩後IAP明顯下降而腹腔灌註壓明顯增高，血流動力學保持不變。臨床上需加大研究力度，以便更為準確地確定孕產婦的正常IAP範圍，為高危IAH和ACS的有效防治提供參攷依據。
목적：비교임신정상부녀재분면전후적복강내압여혈류동역학적변화차이。방법납입2011년11월～2012년3월의재엄주의학원제삼부속의원진행분면적임신부녀24례진행연구，근거임신유별분위단태임신조（20례）급쌍태임신조（4례），우분면전후사용방광내압방법감측기복강내압변화，병관찰혈압、복강관주압급심솔적변화。결과（1）단태임신부녀분면후적수축압급서장압의차위（118.05±10.12）mm Hg、（70.95±7.65）mm Hg，여분면전비교무통계학의의（P＞0.05）；분면후산부적심솔위（83.76±11.31）차/min，교분면전적（95.29±14.11）차/min유현저하강，차분면후복강관주압교분면전야유명현제승，전후비교차이유통계학의의（P＜0.01）；（2）분면전단태임신부녀적IAP파동범위위14.28～48.96mmHg，평균（35.13±8.81）mm Hg，복내고압（IAP고우12mm Hg）솔100%，분면후IAP범위칙위8.84～25.84mm Hg，평균（16.16±4.61mm Hg），복내고압솔위85.7%（18/21），분면전후대비차이유통계학의의（P＜0.01）。（3）쌍태임신부녀분면전IAP위（38.25±10.18）mm Hg，균속우복내고압；분면후IAP칙위（22.61±10.98）mm Hg，기중복내고압자점75%（3/4）；분면후IAP교분면전하강명현（P＜0.01）。결론정상부녀임신만기적IAP명현증고，분면후IAP명현하강이복강관주압명현증고，혈류동역학보지불변。림상상수가대연구력도，이편경위준학지학정잉산부적정상IAP범위，위고위IAH화ACS적유효방치제공삼고의거。
ObjectiveTo compare the changes of intra-abdominal pressure (IAP) and hemodynamic differences before and after delivery in the normal pregnant women.Methods24 pregnant women,who were going to deliver in the Third Affiliated Hospital of Guangzhou Medical College from November 2011 to March 2012,were divided into a single pregnancy group (20 cases) and a twin pregnancy group (4 cases) according to the pregnant categories.Then the changes of intra-abdominal pressure before and after delivery were monitored by intravesical pressure measurement,in additional,the changes of blood pressure,abdominal perfusion pressure and heart rate were observed.Results(1) In the single pregnancy group,the systolic blood pressure and diastolic blood pressure of the pregnant women after delivery were (118.05±10.12)mm Hg and (70.95±7.65)mm Hg respectively,with no significant differences from those before delivery (P>0.05);While maternal heart rate after the delivery was(83.76±11.31)/min,which was significantly decreased compared with that before delivery of (95.29±14.11)/min,and abdominal perfusion pressure increased significantly than that before delivery,and the differences were significant (P<0.01).(2)The IAP range of women with singleton pregnancy was from 14.28 to 48.96mm Hg with an average of (35.13±8.81)mm Hg before delivery, so the incidence of intra-abdominal hypertension (IAP high 12mmHg) was 100%;While IAP range after delivery was from 8.84 to 25.84 mmHg with an average of(16.16±4.61)mm Hg,so the incidence of intra-abdominal hypertension was 85.7% (18/21),there was a significant difference before and after childbirth (P<0.01).(3)The IAP of women with twin pregnancy before delivery was (38.25±10.18)mm Hg,which was in the range of intra-abdominal hypertension;While that after delivery was (22.61±10.98)mm Hg,only 75% (3/4)of those were diagnosed intra-abdominal hypertension. In short,IAP decreased significantly after delivery (P<0.01). Conclusion The IAP of normal women increased significantly during late pregnancy,with a significant descent of IAP and an elevation of abdominal perfusion pressure after childbirth and without any hemodynamic changes.It's time to strengthen the research about that in clinic,in order to determine the normal range of IAP in pregnant women more accurately,and to provide reference for effective prevention and treatment of high-risk IAH and abdominal compartment syndrome.
