Spencer Penny, Kinsman Leigh, Fuzzard Kim
ANUM Critical Care Unit, Bendigo Health, P.O. Box 126, Bendigo, Vic 3552, Australia.
Aust Crit Care. 2008 Feb;21(1):18-28. doi: 10.1016/j.aucc.2007.10.005. Epub 2008 Jan 16.
Abdominal compartment syndrome (ACS) is a life-threatening syndrome that is increasing in incidence amongst critically ill patients. A 2005 survey of critical care nurses revealed that there were recognised knowledge deficits of ACS amongst surveyed nurses. The purpose of this review is to inform critical care nurses about ACS and its antecedent, intra abdominal hypertension (IAH). Detection techniques, causes, clinical manifestations and pathophysiology of IAH and ACS will be outlined and medical and nursing management will be reviewed. The incidence of ACS is reported to be up to 35% in the intensive care population with reduced survival when compared to other intensive care patients. Physiological changes that occur with ACS include compromise to the cardiovascular, respiratory, renal and neurological systems and development of metabolic acidosis. Management may incorporate percutaneous drainage of ascitic fluid, use of muscle relaxants, prone positioning and surgical intervention to open, decompress and gradually close the abdomen. Throughout this care the critical care nurse should ensure accurate monitoring of organ function, assessment for recurrence of ACS as well as the amount and type of drainage, appropriate wound management and provision of physical and psychosocial support of the patient. These aspects of care have the potential to impact significantly on patient outcome.
腹腔间隔室综合征（ACS）是一种危及生命的综合征，在重症患者中的发病率正在上升。2005年对重症监护护士的一项调查显示，被调查护士对ACS存在公认的知识缺陷。本综述的目的是让重症监护护士了解ACS及其前驱病症——腹腔内高压（IAH）。将概述IAH和ACS的检测技术、病因、临床表现和病理生理学，并对医疗和护理管理进行综述。据报道，重症监护人群中ACS的发病率高达35%，与其他重症监护患者相比，其生存率降低。ACS发生时的生理变化包括心血管、呼吸、肾脏和神经系统受损以及代谢性酸中毒的发生。治疗可能包括经皮引流腹水、使用肌肉松弛剂、俯卧位以及进行手术干预以打开、减压并逐渐关闭腹腔。在整个护理过程中，重症监护护士应确保准确监测器官功能、评估ACS复发情况以及引流液的量和类型，进行适当的伤口管理，并为患者提供身体和心理社会支持。这些护理方面有可能对患者的预后产生重大影响。
