摘要
目的探讨早期连续血液净化治疗（CBP）腹部创伤术后腹腔高压（IAH）的临床应用价值。方法回顾性分析福建医科大学附属二院重症医学科，2008年9月至2014年3月间收治的35例腹部创伤术后IAH患者临床资料，根据是否进行早期CBP，将患者分为早期CBP组（17例）和对照组（18例）。比较腹腔间隙综合征（ACS）发病例数、IAH持续时间和预后情况；比较两组的平均动脉压、氧合指数（PaO2／FiO2）水平、腹腔压力（IAP）平均值和乳酸水平。IAH持续时间、平均动脉压、PaO2／FiO2、IAP平均值和乳酸水平以-x±s表示，组间比较采用t检验；两组ACS发病例数和死亡例数比较采用χ2检验。结果早期CBP组出现ACS和死亡例数（分别为4例和2例）均较对照组（分别为13例和9例）明显降低，均差异有统计学意义（χ2=8．30，5．93；P〈0．05）；早期CBP组IAH持续时间[（3．22±1．47）d]较对照组[（6．53±2．38）d]缩短（t=4．91，P〈0．05）；早期CBP组的平均动脉压[（92．17±8．37）mmHg]（1mmHg=0．133kPa）和PaO2／FiO2水平（309．80±74．70）均高于对照组[分别为（68．92±8．35）mmHg和（256．60±85．50）]，均差异有统计学意义（t=8．22，2．04；P〈0．05）；而早期CBP组的IAP平均值和乳酸水平[分别为（11．81±1．59）mmol／L和（2．05±1．31）mmol／L]则均低于对照组[分别为（18．38±3．87）mmol／L和（3．35±1．44）mmol／L]，均差异有统计学意义（t=6．50，2．79；P〈0．05）。结论腹部创伤术后腹腔高压的早期CBP是一种能有效降低IAP和预防ACS的治疗措施。
Objective To investigate clinical value of early continuous blood purification （CBP）in intra abdominal hypertension （ IAH ） of postoperative abdominal trauma. Methods The thirty-five patients with IAH of postoperative abdominal trauma in intensive care unit （ICU） of the second affiliated hospital of Fujian medical college from September 2008 to March 2014 were retrospecively analysed, including early CBP group （seventeen cases） and control group （eighteen cases）.The cases with abdominal compartment syndrome （ ACS）, the duration of IAH, prognosis, the mean arterial pressure, the level of oxygenation index （ PaO2/FiO2 ）, the average of IAP and the lactic acid level of two groups were compared.Results The cases of ACS and death in early stage of CBP （four cases and two cases respectively ） were significantly decreased than those in control group （ thirteen-three cases and nine cases respectively） （ χ2 = 8.30,5.93 ; P 〈 0.05 ） ; The duration of IAH [ （3.22±1.47）d] in early stage of CBP was significantly shorter than that in control group[ （ 6.53± 2.38） d] （ t = 4.91 , P 〈0.05） .The mean arterial pressure[ （92.17±8.37） mmHg] （ 1 mmHg = 0.133 kpa） ,the level of PaO2/FiO2（309.8±74.7） in early stage of CBP were higher than those in control group [ （68.92±8.35）mmHg, （256.6±85,5） ] （ t= 8.22,2.04; P 〈0.05）.The average of lAP （11.81±1.59） and the lactic acid level [ （2.05.± 1.31 ）mmol/L] in early CBP were lower than those in control group,[ （18.38±3.87） ,（3.35±1.44）mmol/L] ,（ t=6.50,2.79; P 〈0.05）.Conclusion The use of early CBP in IAH after abdominal trauma operation is the effective treatment measure for reducing lAP and prevention of ACS.
出处
《中华诊断学电子杂志》
2015年第3期56-58,共3页
Chinese Journal of Diagnostics(Electronic Edition)
基金
泉州市科技计划项目(2013Z107)
关键词
腹部创伤术后
腹腔高压
腹腔间隙综合征
早期连续血液净化治疗
After abdominal trauma operation
Intra abdominal hypertension
Abdominal compartment syndrome
Continuous blood purification
