摘要
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±3．91mmHg，P=0．001）及450（25．69±4．09mmHg，P〈0．001）时腹内压比0°（16．31±3．38mmHg）时明显升高，而腹腔灌注压45°（51．92±10．05mmHg，P=0．03）时明显低于0°（60．54±9．86mmHg）；在腹内压正常者30°（11．17±3．24mmHg,P=0．002）及45°（15．59±4．13mmHg，P=0．001）时腹内压比0°（7．23±2．14mmHg）时明显升高，而腹腔灌注压45°（60．78±9．13mmHg，P=0．004）时明显低于0°（71．28±8．86mmHg）。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。
Objective To observe the effects of body positioning on intra-abdominal hypertension （lAP） and abdominal perfusion pressure （APP） in critically ill patients. Methods We investigated 78 patients admitted to ICU and measured their lAP 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 lAP 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.
出处
《岭南现代临床外科》
2014年第3期345-348,共4页
Lingnan Modern Clinics in Surgery
关键词
腹内压
腹腔灌注压
体位
Intra abdominal hypertension
Body position
Abdominal perfusion pressure
