[严重烧伤患者腹腔间隔室综合征的临床分析]
[Clinical analysis of abdominal compartment syndrome in patients with serious burn injury].
作者信息
Song Zhen-qiang, Wang Run-xiu, Nong Qing-wen, Lin Yuan, Liu Da-en, Zhang Li-ming, Feng Li
机构信息
The Center of Plastic & Burn and Rehabilitation, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
出版信息
Zhonghua Shao Shang Za Zhi. 2006 Dec;22(6):462-5.
OBJECTIVE
To summarize the clinical management of abdominal compartment syndrome (ACS) in burn patients with severe burn injury.
METHODS
Twelve serious burn patients with abdominal compartment syndrome hospitalized in our center from January 2001 to April 2005 were enrolled in the study. Among them 3 patients were treated with conservative method, 4 with escharectomy of abdominal wall, 5 with laparotomy for decompression. The clinical results were analyzed statistically. Bladder pressure, central venous pressure, systolic blood pressure and arterial blood oxygen partial pressure (PaO2 ) were measured and compared before and after operation.
RESULTS
Among these 12 patients, 5 died with the overall mortality of 41.67%. But only 3 died among 9 patients undergone operation. Most of patients were oliguric,with abnormal bladder pressure, central venous pressure, and systolic blood pressure 24 hours before operation. But these parameters were significantly improved after operation ( P <0. 01).
CONCLUSION
Early abdominal escharectomy and timely abdominal decompression are vital for the management of ACS in burn patients.
目的
总结重度烧伤患者腹部间隔室综合征（ACS）的临床处理方法。
方法
选取2001年1月至2005年4月在本中心住院治疗的12例合并腹部间隔室综合征的重度烧伤患者。其中3例采用保守治疗，4例行腹壁焦痂切除术，5例行剖腹减压术。对临床结果进行统计学分析。测量并比较手术前后的膀胱压力、中心静脉压、收缩压及动脉血氧分压（PaO₂）。
结果
12例患者中，5例死亡，总死亡率为41.67%。但9例接受手术治疗的患者中仅3例死亡。大多数患者术前24小时少尿，膀胱压力、中心静脉压及收缩压异常。但术后这些参数均有显著改善（P<0.01）。
结论
早期行腹部焦痂切除术及及时进行腹部减压对烧伤患者腹部间隔室综合征的处理至关重要。
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