Incidence and risk factors of high intraabdominal pressure in critically ill patients
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摘要: 目的:观察危重患者腹腔内高压（IAH）的发生率及其影响因素。方法:采用前瞻性队列研究方法,选择我院重症监护病房（ICU）的患者341例,采用经膀胱尿管间接测定方法,每日监测患者IAP,连续监测7d,按IAH的有无分组并进行临床资料比较,计量资料用t检验,计数资料用χ2检验,危险因素以单因素及多因素Logistic回归模型进行分析。结果:341例患者中88例（25.8%）患者发生腹腔内高压（IAH）,15例（4.5%）患者发生腹腔间室综合征（ACS）。腹腔感染,大量液体复苏,肠梗阻,感染性休克,肝功能不全与IAH的发生密切相关（P=0.000,0.000,0.007,0.000,0.000）。结论:IAH的发生在危重患者中较常见,腹腔感染,大量液体复苏,感染性休克,肝功能不全可能是IAH发生的独立危险因素。Abstract: Objective:To investigate the incidence and risk factors of high intra abdominal pressure（IAP） in critically ill patients in intensive care unit（ICU）.Method:This was a prospective cohort study.This study was conducted at the intensive care unit in Changshu No.2 people’s hospital.The enrolled patients included all those consecutively admitted during 9 months.Intraabdominal pressure was continuously monitored twice daily for 7 days.Result:Of 341patients,88 patients（25.8%）had intra-abdominal hypertension and 15 patients（4.5%） had ACS.Independent risk factors for IAH were abdominal infection,fluid resuscitation,sepsis shock and liver dysfunction.Conclusion:IAH was frequent in Intensive Care Unit.Abdominal infection,fluid resuscitation,sepsis shock and liver dysfunction were independent risk factors for IAH.
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