Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH...Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH is prevalent in about half of the critically ill patients in the medical intensive care units(ICU)and has been widely recognized as an independent risk factor for mortality.It is alarming to note that many members of the critical care team in medical ICU are not aware of the consequences of untreated IAH and the delay in making the diagnosis leads to increased morbidity and mortality.Frequently it is underdiagnosed and undertreated in this patient population.Elevated intraabdominal pressure decreases the blood flow to the kidneys and other abdominal viscera and also results in reduced cardiac output and difficulties in ventilating the patient because of increased intrathoracic pressure.When intraabdominal hypertension is not promptly recognized and treated,it leads to abdominal compartment syndrome,multiorgan dysfunction syndrome and death.Large volume fluid resuscitation is very common in medical ICU patients presenting with sepsis,shock and other inflammatory conditions like pancreatitis and it is one of the major risk factors for the development of intra-abdominal hypertension.This article presents an overview of the epidemiology,definitions,risk factors,pathophysiology and management of IAH and abdominal compartment syndrome in critically ill medical ICU patients.展开更多
目的：探讨重症急性胰腺炎腹内高压及腹腔间隙综合征患者腹内压动态监测意义和护理方法。方法：选择我院急诊外科2012年7月-2014年7月收治的重症急性胰腺炎患者39例,给予常规护理和支持治疗,包括禁食水、胃肠减压、芒硝外敷、抑制胰腺...目的：探讨重症急性胰腺炎腹内高压及腹腔间隙综合征患者腹内压动态监测意义和护理方法。方法：选择我院急诊外科2012年7月-2014年7月收治的重症急性胰腺炎患者39例,给予常规护理和支持治疗,包括禁食水、胃肠减压、芒硝外敷、抑制胰腺分泌药物使用;使用Ab Viser Auto Valve腹内压监测设备,动态测定膀胱压代替腹内压,发现腹内高压及时采取减压措施和护理干预。结果：39例重症急性胰腺炎患者痊愈31例,好转2例,转院重症监护室1例,自动出院1例,死亡4例。平均住院天数（23.25±4.18）d。结论：动态监测重症急性胰腺炎患者的腹内压,可及时发现腹内高压,预防腹腔间隙综合征发生,为腹腔间隙综合征患者的诊治提供客观依据,缩短住院时间,降低病死率。展开更多
BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).ME...BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).METHODS: The patients, who were randomized into an ENOTES group and an operative group, underwent ENOTES and laparotomy, respectively. The results and complications of the two groups were compared.RESULTS: Enterocinesia was observed earlier in the ENOTES group than in the operative group. Acute Physiology and Chronic Health Evaluation II(APACHE II) score of patients in the ENOTES group was lower than that of the operative group on the 1st, 3rd and 5th post-operative day(P<0.05). The cure rate was 96.87% in the ENOTES group, which was statistically different from 78.12% in the operative group(P<0.05). There were significant differences in complications and mortality between the two groups(P<0.01).CONCLUSION: Compared with surgical decompression, ENOTES associated with flexible endoscope therapy is an effective and minimal invasive procedure with less complications.展开更多
文摘Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH is prevalent in about half of the critically ill patients in the medical intensive care units(ICU)and has been widely recognized as an independent risk factor for mortality.It is alarming to note that many members of the critical care team in medical ICU are not aware of the consequences of untreated IAH and the delay in making the diagnosis leads to increased morbidity and mortality.Frequently it is underdiagnosed and undertreated in this patient population.Elevated intraabdominal pressure decreases the blood flow to the kidneys and other abdominal viscera and also results in reduced cardiac output and difficulties in ventilating the patient because of increased intrathoracic pressure.When intraabdominal hypertension is not promptly recognized and treated,it leads to abdominal compartment syndrome,multiorgan dysfunction syndrome and death.Large volume fluid resuscitation is very common in medical ICU patients presenting with sepsis,shock and other inflammatory conditions like pancreatitis and it is one of the major risk factors for the development of intra-abdominal hypertension.This article presents an overview of the epidemiology,definitions,risk factors,pathophysiology and management of IAH and abdominal compartment syndrome in critically ill medical ICU patients.
文摘目的：探讨重症急性胰腺炎腹内高压及腹腔间隙综合征患者腹内压动态监测意义和护理方法。方法：选择我院急诊外科2012年7月-2014年7月收治的重症急性胰腺炎患者39例,给予常规护理和支持治疗,包括禁食水、胃肠减压、芒硝外敷、抑制胰腺分泌药物使用;使用Ab Viser Auto Valve腹内压监测设备,动态测定膀胱压代替腹内压,发现腹内高压及时采取减压措施和护理干预。结果：39例重症急性胰腺炎患者痊愈31例,好转2例,转院重症监护室1例,自动出院1例,死亡4例。平均住院天数（23.25±4.18）d。结论：动态监测重症急性胰腺炎患者的腹内压,可及时发现腹内高压,预防腹腔间隙综合征发生,为腹腔间隙综合征患者的诊治提供客观依据,缩短住院时间,降低病死率。
文摘BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).METHODS: The patients, who were randomized into an ENOTES group and an operative group, underwent ENOTES and laparotomy, respectively. The results and complications of the two groups were compared.RESULTS: Enterocinesia was observed earlier in the ENOTES group than in the operative group. Acute Physiology and Chronic Health Evaluation II(APACHE II) score of patients in the ENOTES group was lower than that of the operative group on the 1st, 3rd and 5th post-operative day(P<0.05). The cure rate was 96.87% in the ENOTES group, which was statistically different from 78.12% in the operative group(P<0.05). There were significant differences in complications and mortality between the two groups(P<0.01).CONCLUSION: Compared with surgical decompression, ENOTES associated with flexible endoscope therapy is an effective and minimal invasive procedure with less complications.
