浙江医学Issue(9)：728-731,4.
腹腔压监测在脓毒症休克患者液体复苏中的临床意义
Application of intra-abdominal pressure monitoring for fluid resuscitation in patients with septic shock
摘要
Abstract
Objective To evaluate the application of intra- abdominal pressure monitoring for fluid resuscitation in pa-tients with septic shock. Methods Total 142 septic shock patients with abdominal pressure (IAP)<10mmHg were admitted in ICU from January 2011 to 2014 June, among whom 64 cases with IAP>17mmHg within 24h achieving the standards after early fluid resuscitation were enrol ed in the study. According to different liquid management scenarios, patients were randomly divided into limited fluid resuscitation group (n=32) and non- limited fluid resuscitation group (n=32). The liquid management was imple-mented under PiCCO (pulse induced contour cardiac output) monitoring. The abdominal pressure, PiCCO parameters, total vol-ume of liquid and ScVO2 were compared between two groups. The incidence of acute kidney injury (AKI) and abdominal com-partment syndrome (ACS), duration of mechanical ventilation and 28- day fatality rate were compared between two groups after 28d. Results Comparing with non- limited fluid resuscitation group, the total amount of liquid, incidence of AKI and ACS within 72h in resuscitation group were significantly lower(P<0.05). The IAP, EVLWL and mechanical ventilation in limited fluid resuscita-tion group were lower than those of non- limiting fluid resuscitation group(P<0.05). There was no significant difference in 28d- fa-tality between two groups (P>0.05). Conclusion Continuous monitoring of bladder pressure during fluid resuscitation in septic shock patients can timely detect abdominal hypertension. The limited fluid resuscitation to control abdominal pressure (≤17mmHg) can reduce the incidence of ACS and AKI, shorten the mechanical ventilation for septic shock patients with IAP≥17mmHg after early standardized resuscitation.关键词
脓毒症休克/腹腔压监测/限制性液体复苏Key words
Septic shock/Intra- abdominal pressure monitoring/Limited fluid resuscitation引用本文复制引用
罗建,王丹琼,张伟文..腹腔压监测在脓毒症休克患者液体复苏中的临床意义[J].浙江医学,2015,(9):728-731,4.基金项目
衢州市科技计划项目 （）
