摘要
目的 研究腹腔内高压和腹腔间室综合征的概念及其病理生理变化。方法 采用文献回顾的方法对腹腔内高压和腹腔间室综合征的概念及病理生理学进展加以综述。结果 腹腔内高压和腹腔间室综合征的概念已逐渐被接受 ,其病理生理变化主要有 :①胃肠血流减少 ;②呼吸道阻力增加 ,肺顺应性下降 ;③心输出量减少 ,周围循环阻力增加 ;④少尿甚至无尿 ;⑤颅内压升高 ;⑥肝脏血流减少 ;⑦腹壁顺应性降低。结论 腹腔内高压和腹腔间室综合征的概念应用增多 ,最易累及呼吸系统、心血管系统和泌尿系统 ,其次是胃肠道、中枢神经系统、肝脏和腹壁。心输出量减少和肺顺应性下降是引起脏器功能障碍的始动因素。
Objective To study the concepts and pathophysiology of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Methods Relevant information was gathered from previous original articals,and by checking the latest issues of appropriate journals. Meantime computerised MEDLINE search from 1998 to August 2001 was conducted using the Medical Subject Heading and textwords 'abdominal', 'compartment syndromes', 'intra abdominal' and 'hypertention' and 'pressure'.Then the literature in the recent two years about the advances of IAH and ACS were reviewed. Especially the concepts, pathophysiology and clinical application of IAH and ACS were mainly summarized.Results Akin to compartment syndrome, the pathophysiological effects of increased intra abdominal pressure developed well before any clinical evidence of compartment syndrome. These changes included ①reduction of gastro intestinal blood flow,②increase of respiratory airway pressure whereas decrease of pulmonary compliance,③decline in cardiac output but rise in peripheral vascular pressure,④oliguria even anuria,⑤increase of intra cranial pressure,⑥decrease of hepatic blood flow,⑦decrease of abdominal wall compliance.ACS can be defined as dysfunction of various organs caused by a progressive unphysiologic increase of the intra abdominal pressure. Clinically the syndrome is characterised by inadequate ventilation, tensely distended abdomen and oliguria or anuria.Early decompression by simple laparotomy and delayed closure is the treatment of choice. Conclusion The concepts of IAH and ACS have been increasingly accepted. They mainly affects the respiratory,cardiovascular and renal systems; secondarily affect gastro intestinal, central nervous systems,liver and abdominal wall. The reduction of cardiac output and pulmonary compliance are probably promoting factors inducing organ dysfunction.
出处
《中国普外基础与临床杂志》
CAS
2002年第6期451-453,共3页
Chinese Journal of Bases and Clinics In General Surgery
