本文選題：腹內(nèi)壓 + 腹腔內(nèi)高壓　； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的1.觀察ICU患者不同水平腹內(nèi)壓（IAP）下腎功能的變化，分析二者的影響因素。2.探討腹腔內(nèi)高壓（IAH）與急性腎功能衰竭（ARF）的關(guān)系。 方法2011年1月至2013年1月廣西醫(yī)科大一附院ICU收治所有危重癥患者，入科后即應(yīng)用膀胱測(cè)壓法監(jiān)測(cè)腹內(nèi)壓，共133例。根據(jù)不同腹內(nèi)壓水平分成5組，非IAH組67例，I級(jí)組（IAP12-15mmHg）31例，II級(jí)組（16-20mmHg）15例，，III級(jí)組（21-25mmHg）17例，IV級(jí)組（IAP＞25mmHg）3例，所有患者均于入住ICU即日開(kāi)始監(jiān)測(cè)IAP，每6小時(shí)記錄１次IAP。IAH出現(xiàn)24小時(shí)內(nèi)，同時(shí)監(jiān)測(cè)血肌酐、尿素氮、胱抑素C、24小時(shí)尿量、24小時(shí)輸液量、平均動(dòng)脈壓。同時(shí)對(duì)患者入科24小時(shí)、首次出現(xiàn)腹內(nèi)高壓時(shí)和腹內(nèi)壓力最高時(shí)分別進(jìn)行APACHEII、MODS、SOFA評(píng)分。對(duì)不同水平腹內(nèi)壓下患者的資料進(jìn)行相關(guān)性分析。 結(jié)果不同水平腹內(nèi)壓與腎功能、APACHEII評(píng)分、MODS評(píng)分呈相關(guān)性，腹腔內(nèi)高壓（IAH）與急性腎功能衰竭（ARF）呈相關(guān)性，不同水平腹內(nèi)壓下行CRRT、腹水穿刺引流，有助于腎功能的改善。 結(jié)論應(yīng)常規(guī)監(jiān)測(cè)ICU患者的腹內(nèi)壓（IAP）變化，及早發(fā)現(xiàn)腹腔內(nèi)高壓（IAH），積極干預(yù)和治療，如CRRT、腹水穿刺引流，有助于腎功能的改善、預(yù)防急性腎功能衰竭（ARF）的發(fā)生。
[Abstract]:Objective 1.To observe the changes of renal function in patients with ICU under different levels of intraabdominal pressure, and to analyze the influencing factors. 2. 2.To investigate the relationship between intraperitoneal hypertension (IAH) and acute renal failure (ARF).Methods from January 2011 to January 2013, all critically ill patients were treated in ICU of the first affiliated Hospital of Guangxi Medical University. After admission, intraabdominal pressure was monitored by bladder manometry in 133 cases.Blood creatinine, urea nitrogen and cystatin C were monitored 24 hours urine volume and 24 hours infusion volume, mean arterial pressure.At the same time, Apache II MODS sofa score was used for 24 hours, the first abdominal hypertension and the highest intraabdominal pressure.The data of patients with different levels of intraabdominal pressure were analyzed.Results different levels of intra-abdominal pressure were correlated with APACHEII score and mods score, intraperitoneal hypertension (IAH) was correlated with acute renal failure (ARF). CRRTand drainage of ascites under different levels of intra-abdominal pressure were helpful to the improvement of renal function.Conclusion it is necessary to routinely monitor the changes of intraabdominal pressure (ICU) in patients with ICU, to detect intraperitoneal hypertension early, and to intervene and treat actively, such as CRRT, drainage of ascites, which is helpful to improve renal function and prevent the occurrence of acute renal failure (ARF).
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692.5

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相關(guān)期刊論文 前2條

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本文編號(hào)：1735303