Sugrue Michael, Buhkari Yasir
Department of Surgery, Letterkenny General Hospital and Galway University Hospitals, Letterkenny, Donegal, Ireland.
World J Surg. 2009 Jun;33(6):1123-7. doi: 10.1007/s00268-009-0040-4.
Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death.
Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation.
All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.
腹内压（IAP）是腹内病变的先兆，其测量成本低廉、操作简单且可重复。腹内高压（IAH），尤其是3级和4级（IAP>18 mmHg），在超过三分之一的患者中出现，并与腹内感染、出血、肾衰竭及死亡风险增加相关。
IAP读数升高可为外科医生提供客观的床边刺激，促使其加快对危重症患者的诊断和治疗工作。全球外科医生和重症监护医生面临的最大挑战之一是未认识到IAH、腹腔间隔室综合征（ACS）与腹内感染之间的已知关联。对IAH及其进展为ACS缺乏认识可能会延迟及时干预，并导致对患者过度复苏。
所有在急诊普通外科手术后或接受大量液体复苏后进入重症监护病房（ICU）的患者，均应每6小时测量一次IAP。每个ICU都应制定与IAP测量技术相关的指南以及IAH管理算法。
