摘要
目的探讨肝移植术后腹内压监测的临床意义。方法2003年9月至2005年1月,采用膀胱内压检测法间接测量腹内压,术后每天腹内压>20mmHg(1mmHg=0.133kPa)时定为腹内高压(IAH)。比较腹内高压组与正常组的原发病因、手术方式、术中相关指标及愈后。记录病人术后0～72h的腹内压、肾功能相关指标,血流动力学指标以及动脉血氧分压/吸入氧浓度比,同时记录病人的机械通气时间和术后第4天的肝功能。结果腹内高压组与正常组比较,手术时间、术中补液量、术中输血量及术后急性肾衰、呼吸衰竭的发生率差异有显著性,术后24～72h血肌酐、血尿素氮水平、每小时尿量以及心率、动脉血氧分压/吸入氧浓度比、机械通气时间也存在显著不同。结论肝移植术后并发的腹内高压对器官功能的损害是快速、多部位的,最常见的损害是肾功能与呼吸功能。重视腹内高压、术后早期腹内压的严密监测具有较重要的临床意义。
Objective To investigate the clinical significance of monitoring intra-abdominal pressure after liver transplantation by summarizing the data of 62 cases of liver transplantation.Methods Intra-abdominal pressure was indirectly measured by intravesical pressure and intra-abdominal pressure over 20mmHg was regarded as intra-abdominal hypertension (IAH).The etiological factor,operation manner,intra-operate relevant parametes and prognosis of two groups were contrasted.The postoperative intra-abdominal pressure,the parametes of renal function and hemodynamics,fraction of arterial oxygen partial pressure/inspired oxygen for 0~72h,the marker of hepatic function at the fourth day and time of mechanical ventilation were recorded.Results The IAH group had had more operation time,intraopertive fluids and transfusion,and the frequency of acute renal and respiratory failures was much higher.There were obvious difference between these two groups in levels of blood creatinine,blood urea nitrogen,urine volume per hour and heart rate,fraction of arterial oxygen partial pressure/inspired oxygen and time of mechanical ventilation.Conclusion Intra-abdominal hypertension impairs multiple organs functions rapidly,especially to renal and respiratory function of patients underwent liver transplantation.It is worthy of monitoring intra-abdominal pressures in those subjects.
出处
《中国实用外科杂志》
CSCD
北大核心
2005年第6期353-356,共4页
Chinese Journal of Practical Surgery
关键词
腹内压
肾功能
呼吸功能
肝移植术
Liver transplantation Intra-abdominal pressure Intra-abdominal hypertension
