Sonne Morten Egede, Hillingsø Jens G, Hestad Søren, Svendsen Lars Bo, Antonsen Kristian
Nordsjaellands Hospital, Hillerød.
Ugeskr Laeger. 2007 Feb 19;169(8):705-10.
Over the past number of years, there has been an increasing interest in the pathophysiological phenomena intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Foreign studies have shown considerably national differences in the interpretation of the two phenomena. The purpose of this questionnaire study was to survey which group of patients is examined for IAH and ACS, how the examination is carried out and how the two conditions are treated in surgical and intensive care units in Denmark.
A questionnaire was sent to all relevant surgical and intensive care units in Denmark.
The response rate was 81%. 74% intensive care units and 31% surgical wards measured IAP. 100% used the intravesical method. International guidelines were followed in 11% of surgical wards and 18% of the intensive care units regarding how often IAP should be measured and 44%/ 32% regarding at what IAP level surgical intervention should be considered. 78% of the wards and 79% of the intensive care units that measured IAP had celiotomy as a treatment modality. There were major differences between both surgical wards and intensive care units regarding which group of patients should have IAP measured.
Considering the differences in clinical practice and the discrepancy to international guidelines interdisciplinary national guideline might contribute to a more uniform evaluation and treatment of patients with IAH or ACS.
在过去数年里，人们对腹内高压（IAH）和腹腔间隔室综合征（ACS）的病理生理现象越来越感兴趣。国外研究表明，在对这两种现象的解读上存在相当大的国别差异。本问卷调查研究的目的是调查丹麦的外科和重症监护病房中，哪些患者群体接受了IAH和ACS检查，检查是如何进行的，以及这两种病症是如何治疗的。
向丹麦所有相关的外科和重症监护病房发送了一份问卷。
回复率为81%。74%的重症监护病房和31%的外科病房测量了腹内压（IAP）。100%采用膀胱内测量法。在测量IAP的频率方面，11%的外科病房和18%的重症监护病房遵循国际指南；在考虑进行手术干预的IAP水平方面，分别有44%/32%遵循国际指南。测量IAP的病房中有78%以及重症监护病房中有79%将剖腹术作为一种治疗方式。在哪些患者群体应测量IAP方面，外科病房和重症监护病房之间存在重大差异。
考虑到临床实践中的差异以及与国际指南的不一致，制定跨学科的国家指南可能有助于更统一地评估和治疗IAH或ACS患者。
