Schachtrupp A, Jansen M, Bertram P, Kuhlen R, Schumpelick V
Klinik für Allgemein-, Gefäss- und Viszeral-Chirurgie, Marienhospital, Rochusstrasse 2, 40479 Düsseldorf.
Anaesthesist. 2006 Jun;55(6):660-7. doi: 10.1007/s00101-006-1019-2.
A pathological increase of intraabdominal pressure (IAP) is frequently observed in severely ill patients suffering from surgical diseases. This may lead to the abdominal compartment syndrome (ACS) which is characterized by an IAP >20 mmHg (>2.67 kPa) and failure of one or more organ systems. The mortality of ACS exceeds 60%. Knowledge concerning the sequelae of ACS is abundant, however, measurement of IAP is not routinely performed even if patients present with corresponding risk factors. This is probably due to a variable incidence of ACS and scepticism regarding the results of bladder pressure measurement. However, measurement of IAP can now be performed semi-automatically, continuously and in a standardized fashion. The therapy of ACS, i.e. decompression laparotomy and laparostomy, is undisputed. Since a heterogeneous group of patients can be affected, monitoring of IAP is indicated in patients needing intensive care. A consistent registration of IAP will improve knowledge and guidelines regarding the therapy of a pathologically increased IAP. Nevertheless, patients in whom ACS is suspected should be decompressed as soon as possible.
在患有外科疾病的重症患者中，经常观察到腹腔内压力（IAP）病理性升高。这可能导致腹腔间隔室综合征（ACS），其特征为IAP>20 mmHg（>2.67 kPa）且一个或多个器官系统功能衰竭。ACS的死亡率超过60%。关于ACS后遗症的知识很多，然而，即使患者存在相应的危险因素，IAP测量也未常规进行。这可能是由于ACS的发病率不一以及对膀胱压力测量结果存在怀疑。然而，现在可以以半自动、连续且标准化的方式进行IAP测量。ACS的治疗，即减压剖腹术和剖腹造口术，是无可争议的。由于可能影响到不同类型的患者群体，因此在需要重症监护的患者中，建议监测IAP。对IAP进行一致的记录将改善关于病理性升高IAP治疗的知识和指南。尽管如此，怀疑患有ACS的患者应尽快进行减压。
