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目的研究重度烧伤患者腹腔内高压(IAH)的发生现状,探讨其影响因素,为减少患者IAH发生的临床干预提供依据。方法选择2013年7月—2014年6月收治的重度烧伤患者154例作为研究对象,烧伤严重程度分类依据《美国烧伤协会严重程度分类系统》,采用膀胱间接无创腹内压测压法,每次间隔5 min重复测量3次取平均值。结果 154名重度烧伤患者中发生IAH的有63人(40.91%),腹内压(IAP)平均值为(10.88±5.00)mm Hg,IAH发生组与IAH未发生组IAP差异有统计学意义(P<0.05);不同组别的重度烧伤患者输液总量、血白蛋白含量不同,差异有统计学意义(P<0.05);肥胖,腹部焦痂,创面感染、腹腔内液体均是重度烧伤患者IAH发生的影响因素(P<0.05)。结论重度烧伤患者IAH发生率较高,医务人员应加强对患者IAP的动态监测,减少IAH的发生,改善重度烧伤患者的预后。
Objective To study the status of intra-abdominal hypertension (IAH) in patients with severe burns and to explore its influencing factors, so as to provide basis for reducing the clinical intervention in patients with IAH. Methods A total of 154 patients with severe burn admitted to our hospital from July 2013 to June 2014 were enrolled in this study. The severity of the burn was classified according to the classification system of the severity of the American Burn Association. Noninvasive intra-abdominal pressure manometry 5 min interval repeated measurements were averaged. Results There were 63 (40.91%) patients with IAH in the group of 154 patients with severe burn and the mean IAP (10.88 ± 5.00) mm Hg in the group of 154 patients with severe burn. There was significant difference in IAP between IAH group and IAH group P <0.05). The total amount of infusion and serum albumin in patients with severe burn in different groups were significantly different (P <0.05). Obesity, abdominal eschar, wound infection and intraperitoneal fluid were all severe burn patients The influencing factors of IAH (P <0.05). Conclusion The incidence of IAH in patients with severe burn is high. Medical staff should strengthen the dynamic monitoring of IAP, reduce the incidence of IAH and improve the prognosis of severe burn patients.