Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China.
J Gastrointest Surg. 2011 Aug;15(8):1426-32. doi: 10.1007/s11605-011-1553-3. Epub 2011 May 10.
Intra-abdominal hypertension is common in patients with severe acute pancreatitis. The aim of this study was to assess the clinical relevance of intra-abdominal pressure and abdominal perfusion pressure in the first 72 h after admission during severe acute pancreatitis.
From January 2009 to February 2011, 50 patients admitted for severe acute pancreatitis were included in this prospective, observational study. The intra-abdominal pressure and abdominal perfusion pressure level were repeatedly measured every 12 h during the first 72 h. The maximum and the mean values of intra-abdominal pressure and the minimum and mean values of abdominal perfusion pressure were used for analysis.
Both the maximum and mean levels of intra-abdominal pressure were significantly different between patients with or without kinds of clinical variables. But for abdominal perfusion pressure, difference could only be detected in terms of need of vasoactive drugs. Besides that, different from abdominal perfusion pressure, intra-abdominal pressure is associated with high incidence rates of MODS and secondary infection.
Compared with abdominal perfusion pressure, intra-abdominal pressure is much more valuable as an early marker of the evolution and complications of severe acute pancreatitis.
腹腔内高压在重症急性胰腺炎患者中很常见。本研究旨在评估入院后 72 小时内腹腔内压和腹部灌注压在重症急性胰腺炎中的临床相关性。
2009 年 1 月至 2011 年 2 月，本前瞻性观察性研究纳入了 50 例因重症急性胰腺炎入院的患者。在入院后 72 小时内，每隔 12 小时重复测量腹腔内压和腹部灌注压水平。使用腹腔内压的最大值和平均值以及腹部灌注压的最小值和平均值进行分析。
腹腔内压的最大值和平均值在有或无各种临床变量的患者之间存在显著差异。但是，对于腹部灌注压，仅在需要血管活性药物的情况下才能检测到差异。此外，与腹部灌注压不同，腹腔内压与多器官功能障碍综合征和继发感染的高发生率有关。
与腹部灌注压相比，腹腔内压作为重症急性胰腺炎演变和并发症的早期标志物更有价值。
