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腹腔间隔室综合征

Abdominal compartment syndrome.

作者信息

Cheatham Michael Lee

机构信息

Surgical Intensive Care Units, Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida 32806, USA.

出版信息

Curr Opin Crit Care. 2009 Apr;15(2):154-62. doi: 10.1097/MCC.0b013e3283297934.

Abstract

PURPOSE OF REVIEW

Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS), the pathophysiologic implications of elevated intraabdominal pressure (IAP), have detrimental effects on all organ systems and are associated with significant morbidity and mortality. Within the past few years, the diagnosis and management of these syndromes have evolved tremendously.

RECENT FINDINGS

Consensus definitions and recommendations for the diagnosis and management of IAH/ACS have been proposed. Risk factors for IAH/ACS have been clearly defined. The timing and techniques for IAP measurement have been further described. A comprehensive evidence-based medical and surgical approach to the treatment of IAH/ACS has been developed.

SUMMARY

Liberal IAP measurement in the presence of known risk factors combined with implementation of an evolving and comprehensive resuscitation strategy have resulted in significant improvements in both short and long-term outcome for patients who develop IAH/ACS. All clinicians should be aware of the risk factors that predict development of IAH/ACS, the appropriate measurement of IAP, and the current resuscitation options for managing these highly morbid syndromes.

摘要

综述目的

腹腔内高压(IAH)和腹腔间隔室综合征(ACS)是腹腔内压力(IAP)升高的病理生理表现,对所有器官系统均有不利影响,并与显著的发病率和死亡率相关。在过去几年中,这些综合征的诊断和管理有了巨大进展。

最新发现

已提出IAH/ACS诊断和管理的共识定义及建议。IAH/ACS的危险因素已明确界定。IAP测量的时机和技术得到了进一步描述。已制定出基于循证医学和外科的IAH/ACS综合治疗方法。

总结

在存在已知危险因素时广泛测量IAP,并结合实施不断发展的综合复苏策略,已使发生IAH/ACS患者的短期和长期结局均有显著改善。所有临床医生都应了解预测IAH/ACS发生的危险因素、IAP的正确测量方法以及管理这些高发病率综合征的当前复苏选择。

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