Clinical relevance of intra-abdominal hypertension in patients with severe acute pancreatitis
Clinical relevance of intra-abdominal hypertension in patients with severe acute pancreatitis
复制标题
DOI：
10.1097/mpa.0b013e318149f5bf
复制
发表时间：
2008-01-01
期刊：
影响因子：
2.9
通讯作者：
Ammori, Basil J.
中科院分区：
文献类型：
--
作者：
Al-Bahrani, Ahmed Z.;Abid, Ghalib H.;Ammori, Basil J.
目的：腹内高压（IAH）会导致腹部创伤和脓毒症患者的器官衰竭，并导致腹腔间隔室综合征（ACS）的发生。本研究旨在探讨重症急性胰腺炎（SAP）患者发生 IAH 的临床意义。方法：入院重症监护的 SAP 患者每天测量腹内压（IAP），记录临床资料，并计算 4 种器官功能障碍评分。结果：18 例 SAP 患者中，11 例（61%）发生 IAH（中位值 20 mm Hg），10 例（56%）发生 ACS。 IAP与4个器官功能障碍评分显着相关；当 IAH 存在时，分数明显高于不存在 IAH 时的分数。入院 IAP 与重症监护的持续时间显着相关。与未发生 IAH/ACS 的患者相比，发生 IAH/ACS 的患者器官衰竭评分明显更高，死亡率也更高。剖腹手术和引流使所有患者的 IAP 平均降低了 -11 mm Hg，并缓解了 IAH/ACS。结论：腹内高压和 ACS 是 SAP 患者的常见表现，并且与器官功能恶化相关。腹内压与器官衰竭的严重程度相关，高入院 IAP 与延长重症监护时间相关。
Objectives: Intra-abdominal hypertension (IAH) contributes to organ failure in patients with abdominal trauma and sepsis and leads to the development of abdominal compartment syndrome (ACS). This study aims to investigate the clinical significance of IAH in patients with severe acute pancreatitis (SAP).Methods: Patients admitted to intensive care with SAP underwent daily measurement of intra-abdominal pressure (IAP), recording of the clinical data, and calculation of 4 organ dysfunction scores.Results: Among 18 patients with SAP, 11 (61%) developed IAH (median, 20 mm Hg), whereas 10 (56%) developed ACS. The IAP correlated significantly with the 4 organ dysfunction scores; the scores were significantly higher when IAH existed than when it did not. The admission IAP correlated significantly with the duration of intensive care stay. Patients who developed IAH/ACS had significantly higher organ failure score and greater mortality compared with those who did not. Laparotomy and drainage reduced the IAP by a median of -11 mm Hg and relieved the IAH/ACS in all patients.Conclusions: Intra-abdominal hypertension and ACS are frequent findings in patients with SAP and are associated with deterioration in organ function. Intra-abdominal pressure correlates with the severity of organ failure, and a high admission IAP is associated with prolonged intensive care stay.