摘要
目的探讨腹内压变化率在评价腹腔内高压症(intra-abdominal hypertension,IAH)患者病情及预后的价值。方法采用经膀胱测压法监测85例IAH患者腹内压(intra-abdominal pressure,IAP),将(第3天平均腹内压-第1天平均腹内压)/第1天平均腹内压×100%的值定为腹内压变化率。检测患者血清C反应蛋白(CRP)水平,并计算急性生理及慢性健康状况评分系统评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)及病死率。结果入住重症监护病房(ICU)第1天时,腹内压变化率≤50%与>50%的患者APACHEⅡ评分及CRP水平比较无显著性差异(P>0.05),而在第3天时,腹内压变化率≤50%患者APACHEⅡ评分及CRP水平分别为(23.83±5.71)分和(197.01±32.05)mg/L,均显著低于腹内压变化率>50%的患者[(35.29±6.28)分和(346.35±60.18)mg/L],差异均有统计学意义(P<0.05)。腹内压变化率与第3天APACHEⅡ评分及CRP水平呈显著正相关(APACHEⅡ:r=0.714,P<0.01;CRP:r=0.835,P<0.01)。腹内压变化率在死亡组与存活组间存在显著差异(P<0.01)。经ROC曲线分析,腹内压变异率对于预测患者死亡率有意义(AUC=0.830,P<0.01)。结论腹内压变化率可反映IAH患者的病情和预后,有望为IAH患者的早期干预治疗提供依据。
Objective To explore the value of the change rate of IAP in evaluating for the condition and prognosis in IAH pa -tients.Methods IAP was indirectly measured by urinary bladder pressure for 85 IAH patients,and the value of [（3 day average IAP-1 day average IAP ）/1 day average IAP ＆#215;100%] was regarded as change rate of IAP .The serum CRP level was detected ,and the A-PACHE II,SOFA score and mortality were calculated .Results On the first day of ICU ,the APACHEⅡscore and serum CRP level of patients of change rate of IAP≤50% and 〉50% were similar （P〉0.05）.But on the third day,the APACHE Ⅱ score and serum CRP level were （23.83 ±5.71） points and （197.01 ±32.05） mg/L in ≤50% group respectively,and （35.29 ±6.28） points and （346.35 ±60.18） mg/L in 〉50%group respectively.There were significant difference between the two groups （P〈0.05）.And the change rate of intra-abdominal pressure was significantly positively related to the 3 d APACHE Ⅱ score and c-reactive protein （ A-PACHE Ⅱ：r=0.714,P〈0.01;CRP：r=0.835,P〈0.01）.There were significant differences in change rate of intra-abdominal pres-sure between the death group and alive group （P〈0.01）.Analysis of the ROC curve showed that there was a significant meaning of the change rate of intra-abdominal pressure for diagnosis of mortality （AUC=0.830,P〈0.01）.Conclusion Change rate of IAP can ef-fectively reflect the condition and prognosis of IAH patients ,and is expected to provide theoretical basis for IAH patients early interven-tion treatment .
出处
《东南国防医药》
2014年第3期246-248,共3页
Military Medical Journal of Southeast China
基金
广东省卫生厅医学科学技术研究基金(WSTJJ20111224430202198008144077)
惠州市医疗卫生科学技术项目(20120802)
关键词
腹内压变化率
腹腔内高压症
预后
APACHE
Ⅱ评分
change rate of intra-abdominal pressure
intra-abdominal hypertension
prognosis
APACHE Ⅱscore
