Sugrue Michael, Bauman Adrian, Jones Felicity, Bishop Gillian, Flabouris Arthas, Parr Michael, Stewart Anthony, Hillman Ken, Deane Stephen A
Department of Surgery and Trauma, University of New South Wales, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, New South Wales 2170, Australia.
World J Surg. 2002 Dec;26(12):1428-31. doi: 10.1007/s00268-002-6411-8. Epub 2002 Sep 26.
This study was designed to establish if clinical examination can accurately predict intraabdominal pressure (IAP). Between August 1998 and March 2000 a prospective blinded observational study of postoperative intensive care unit patients was undertaken at a major trauma center. IAP was measured using an intravesicular technique and compared with clinical evaluation. An IAP of at least 18 mmHg was considered elevated. The sensitivity, specificity, positive predicative value (ppv), negative predictive value (npv), kappa score, and reliability analysis were calculated. A total of 110 patients provided 150 estimates of IAP, which was elevated in 21%. The kappa score was 0.37; sensitivity, 60.9%; specificity, 80.5%; ppv, 45.2%; npv, 88.6%. The mean difference in IAP values between intravesicular readings and clinical estimates was -1.0 +/- 4.1. Prediction of IAP using clinical examination is not accurate enough to replace intravesicular IAP measurements.
本研究旨在确定临床检查能否准确预测腹内压（IAP）。1998年8月至2000年3月，在一家大型创伤中心对术后重症监护病房患者进行了一项前瞻性盲法观察研究。采用膀胱内技术测量IAP，并与临床评估结果进行比较。IAP至少为18 mmHg被视为升高。计算了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、kappa评分和可靠性分析。共有110例患者提供了150次IAP估计值，其中21%升高。kappa评分为0.37；敏感性为60.9%；特异性为80.5%；PPV为45.2%；NPV为88.6%。膀胱内读数与临床估计值之间IAP值的平均差异为-1.0±4.1。使用临床检查预测IAP的准确性不足以替代膀胱内IAP测量。
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