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肥胖经产妇行全腹壁成形术后的腹内压

Intraabdominal pressure after full abdominoplasty in obese multiparous patients.

作者信息

Al-Basti Habib B, El-Khatib Hamdy A, Taha Ahmed, Sattar Hisham Abdul, Bener Abdulbari

机构信息

Department of Plastic Surgery, Hamad General Hospital and Hamad Medical Corporation, Doha, Qatar.

出版信息

Plast Reconstr Surg. 2004 Jun;113(7):2145-50; discussion 2151-5. doi: 10.1097/01.prs.0000122543.44977.46.

Abstract

This study measured intraabdominal pressure in morbidly obese and multiparous patients who underwent abdominoplasty with musculoaponeurotic plication. The purpose of this study was to evaluate any potential adverse effect on pulmonary function by virtue of pulmonary function tests and measurement of peak airway pressure. The study included 43 multiparous, morbidly obese women (mean body mass index, 35.8 kg/m2) with a mean age (+/- SD) of 38.6 +/- 7 years. All had full abdominoplasty and repair of the musculoaponeurotic system during the period from June of 1999 to May of 2002. Forty-three morbidly obese multiparous patients were seen over a period of 24 months. Their intraabdominal pressure was estimated by measuring the intravesical pressure before and after repair of severe diastases (divarication) of the rectus abdominis muscles with severely flaccid myofascial component before using a hydrometer connected to a Foley catheter both before and after repair. All patients had pulmonary function checked before and 2 months after the repair. The study confirmed that there are minimal changes on the intraabdominal pressure parameters compared with measurement before and after full abdominoplasty with plication of the rectus muscles, with minimal to negligible changes in the intrathoracic pressure. These changes are clinically and statistically significant (p < 0.0001). The study also recommended the safety of full abdominoplasty and repair of the musculoaponeurotic system in multiparous and morbidly obese patients. Furthermore, no statistically significant difference was found in pulmonary function parameters before and after surgery in patients with a history of bronchial asthma.

摘要

本研究测量了接受腹直肌鞘折叠腹壁成形术的病态肥胖和经产妇患者的腹内压。本研究的目的是通过肺功能测试和气道峰值压力测量来评估对肺功能的任何潜在不良影响。该研究纳入了43名经产妇、病态肥胖女性(平均体重指数为35.8kg/m²),平均年龄(±标准差)为38.6±7岁。在1999年6月至2002年5月期间,所有患者均接受了全腹壁成形术和腹直肌鞘系统修复。在24个月的时间里观察了43名病态肥胖经产妇患者。在使用连接Foley导管的液体比重计测量腹直肌严重松弛肌筋膜成分的严重分离(腹直肌分离)修复前后的膀胱内压,以此估计她们的腹内压。所有患者在修复前和修复后2个月均进行了肺功能检查。该研究证实,与腹直肌折叠全腹壁成形术前后的测量值相比,腹内压参数变化极小,胸内压变化极小至可忽略不计。这些变化在临床和统计学上具有显著意义(p<0.0001)。该研究还表明了全腹壁成形术和腹直肌鞘系统修复在经产妇和病态肥胖患者中的安全性。此外,有支气管哮喘病史的患者手术前后肺功能参数无统计学显著差异。

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