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  • 陈晓迎,石茜.液体复苏量与急性重症胰腺炎患者腹内高压及肾脏损害的关系[J].第二军医大学学报,2015,36(10):1152-1155    [点击复制]
  • CHEN Xiao-ying,SHI Xi.Correlation of fluid resuscitation volume with intra-abdominal hypertension and renal injury in patients with severe acute pancreatitis[J].Acad J Sec Mil Med Univ,2015,36(10):1152-1155   [点击复制]
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液体复苏量与急性重症胰腺炎患者腹内高压及肾脏损害的关系
陈晓迎,石茜*
0
(重庆医科大学附属第一医院重症医学科/外科ICU, 重庆 400016
*通信作者)
摘要:
目的 探讨液体复苏量与急性重症胰腺炎(SAP)腹内高压(IAH)及肾脏损害的关系。 目的 以60例SAP患者为研究对象,以AbViser法测量腹内压(IAP),根据IAP将研究对象分为正常组、IAH组和腹腔间隔室综合征(ACS)组,统计分析各组的一般情况、死亡率、液体复苏量及肾功能损害情况。 结果 (1) 本研究中IAH发病率为31.67%(19/60),ACS发病率为11.67%(7/60)。正常组、IAH组和ACS组死亡率分别为5.88%(2/34)、21.05%(4/19)和57.14%(4/7),ACS组死亡率高于正常组(P=0.007)。(2) 正常组、IAH组和ACS组3日液体平衡量分别为(4 350±892)、(5 512±1 246)和(5 974±1 765)mL,组间比较差异有统计学意义(P<0.001);总液体累积量分别为(8 530±2 384)、(9 403±2 064)、(13 172±2 409)mL,组间比较差异有统计学意义(P<0.001)。其中ACS组3日液体平衡量及液体累积量均为最高。(3) 正常组、IAH组和ACS组肾功能生化指标血肌酐、尿素氮组间差异均具有统计学意义(P<0.001),ACS组血肌酐、尿素氮水平均高于正常组及IAH组(P<0.05)。 结论 SAP患者前3日液体累积量与IAH甚至ACS的发生密切相关,而IAH将进而导致SAP患者肾功能损伤。
关键词:  腹腔间隔室综合征  腹内高压  急性重症胰腺炎  肾功能
DOI:10.3724/SP.J.1008.2015.01152
投稿时间:2015-07-29修订日期:2015-09-14
基金项目:重庆医科大学附属第一医院基金(HLJJ2014-11).
Correlation of fluid resuscitation volume with intra-abdominal hypertension and renal injury in patients with severe acute pancreatitis
CHEN Xiao-ying,SHI Xi*
(Department of Surgical ICU, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
*Corresponding author.)
Abstract:
Objective To investigate the correlation of fluid resuscitation volume with intra-abdominal hypertension (IAH) and renal injury in patients with severe acute pancreatitis (SAP). Methods Totally 60 patients with SAP from our ICU were recruited in the present study. The intra-abdominal pressure (IAP) was measured by method AbViser. The patients were divided into the following 3 groups according to the different of IAP: the normal group, IAH group and abdominal compartment syndrome (ACS) group. The general information, mortality rate, fluid resuscitation volumes and renal injury were analyzed and compared in the 3 groups. Results (1) The incidence rates of IAH and ACS in our study were 31.67%(19/60) and 11.67% (7/60), respectively. The mortality rates of normal group, IAH group and ACS group were 5.88%(2/34), 21.05%(4/19) and 57.14%(4/7), respectively. The mortality rate of ACS group was significantly higher than that of normal group (P=0.007). (2) The fluid balance volumes of normal group, IAH group and ACS group were (4 350±892), (5 512±1 246) and (5 974±1 765) mL, respectively, with significant differences found among the 3 groups (P<0.001); the total cumulative fluid volumes of the 3 groups were (8 530±2 384), (9 403±2 064) and (13 172±2 409) mL, respectively, also with significant differences found among the 3 groups (P<0.001). ACS group had the highest fluid balance and total cumulative fluid volumes in the first 3 days. (3) There were significant differences in the levels of blood creatinine and urea nitrogen among the 3 groups (P<0.001). The levels of blood creatinine and urea nitrogen of ACS group was significantly higher than those of normal group and IAH group (P<0.05). Conclusion The cumulative fluid of the first 3 days is associated with IAH and even ACS in pateints with SAP, and IAH can further lead to renal injury in patients with SAP.
Key words:  abdiminal compartment syndrome  intra-abdominal hypertension  severe acute pancreatitis  renal function