Sanchez N C, Tenofsky P L, Dort J M, Shen L Y, Helmer S D, Smith R S
Department of Surgery, The University of Kansas School of Medicine-Wichita, 67214, USA.
Am Surg. 2001 Mar;67(3):243-8.
The causes and effects of increased intra-abdominal pressure and abdominal compartment syndrome have been well documented. However, there have been no large series to determine normal intra-abdominal pressure in hospitalized patients. The purpose of this study was to determine normal intra-abdominal pressure in randomly selected hospitalized patients and to identify factors that predict variation in normal intra-abdominal pressure. A total of 77 patients were prospectively enrolled between September 1998 and July 1999. Data obtained included patient demographics (i.e., age, gender, height, weight, and body mass index), reason for hospitalization and bladder catheterization, previous and current surgical status, comorbidities, and intra-abdominal pressures. Intra-abdominal pressure readings were obtained through an indwelling transurethral bladder (Foley) catheter. Data were analyzed by analysis of variance and multiple regression analysis. There were 36 females and 41 males with a mean age of 67.7 years. Average weight, height, and body mass index were 79.6 kg, 1.70 m, and 27.6 kg/m2, respectively. Mean intraabdominal pressure was 6.5 mm Hg (range 0.2-16.2 mm Hg). Body mass index was positively related to intra-abdominal pressure (P < 0.0004). Gender, age, and medical and surgical histories did not significantly affect intra-abdominal pressure. However, using multiple regression analysis, a relationship between intra-abdominal pressure, body mass index, and abdominal surgery was discovered. Intra-abdominal pressure is related to a patient's body mass index and influenced by recent abdominal surgery. Thus, the normal intra-abdominal pressure can be estimated in hospitalized patients by using the derived equation. Knowledge of the expected intra-abdominal pressure can then by used in recognizing when an abnormally high intra-abdominal pressure or abdominal compartment syndrome exists.
腹腔内压力升高及腹腔间隔室综合征的病因和影响已有充分记载。然而,尚无大规模研究来确定住院患者的正常腹腔内压力。本研究的目的是确定随机选择的住院患者的正常腹腔内压力,并识别预测正常腹腔内压力变化的因素。1998年9月至1999年7月期间前瞻性纳入了77例患者。获取的数据包括患者人口统计学信息(即年龄、性别、身高、体重和体重指数)、住院及留置导尿原因、既往和当前手术状态、合并症以及腹腔内压力。通过留置的经尿道膀胱(Foley)导管获取腹腔内压力读数。采用方差分析和多元回归分析对数据进行分析。有36名女性和41名男性,平均年龄为67.7岁。平均体重、身高和体重指数分别为79.6kg、1.70m和27.6kg/m²。平均腹腔内压力为6.5mmHg(范围0.2 - 16.2mmHg)。体重指数与腹腔内压力呈正相关(P < 0.0004)。性别、年龄以及内科和外科病史对腹腔内压力无显著影响。然而,通过多元回归分析,发现腹腔内压力、体重指数和腹部手术之间存在关联。腹腔内压力与患者的体重指数相关,并受近期腹部手术影响。因此,可通过所推导的公式估算住院患者的正常腹腔内压力。知晓预期的腹腔内压力后,便可用于识别何时存在异常高的腹腔内压力或腹腔间隔室综合征。