Papavramidis Theodossis S, Michalopoulos Nick A, Mistriotis George, Pliakos Ioannis G, Kesisoglou Isaak I, Papavramidis Spiros T
Department of Surgery, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.
J Emerg Trauma Shock. 2011 Apr;4(2):194-7. doi: 10.4103/0974-2700.82205.
Drainage of ascitic fluid is a common practice in order to relief the respiratory discomfort of patients.
To determine the relation between the intra-abdominal pressure (IAP) and extracted volume of the ascitic fluid, in order to calculate abdominal compliance (Cabd).
A study was designed at AHEPA University Hospital and analysed with prospectively collected data.
Fifteen patients with tension ascites that had transcutaneous drainage with a wide catheter. The ascitic fluid removed was measured, while the IAP and a Visual Analogue Scale (VAS) score for dyspnea were recorded before and 15 min after the puncture. Cabd was calculated.
The data were analysed with descriptive statistics, paired Student's t-test and Pearson coefficiency.
The predrainage IAP was 18.26 mmHg (SD 1.67 mmHg), while the postdrainage was 14.46 mmHg (SD 1.34 mmHg) (P<0.001). The mean volume of ascitic fluid removed was 1624 mL (SD 861 mL). Cabd after drainage was 414.01 mL/mmHg (SD 139.15 mL/mmHg). A linear correlation was found between ascitic fluid removal and IAP variations. The dyspnea VAS score was 7.5 (SD=0.8) before the drainage and 4.3 (SD=1.0) after the drainage (P<0.001).
The drainage of ascitic fluid reduces IAP, facilitating in this way respiration. Moreover, IAP variation seems to be in linear relation with the volume of ascitic fluid removed. This linear relation between IAP and volume may probably predict the Cabd quite accurately and vice versa. However, larger studies are necessary to safely draw predicting ΔIAP - ΔV (Cabd) diagrams, and determine the optimal ascitic fluid removal to achieve best comforting of the patient and slower fluid reformation.
为缓解患者的呼吸不适，腹腔穿刺放液是一种常见的操作。
确定腹腔内压力（IAP）与抽出的腹水量之间的关系，以便计算腹腔顺应性（Cabd）。
在阿赫帕大学医院设计了一项研究，并对前瞻性收集的数据进行分析。
15例张力性腹水患者采用粗导管经皮引流。测量抽出的腹水量，同时在穿刺前和穿刺后15分钟记录IAP和呼吸困难视觉模拟评分（VAS）。计算Cabd。
采用描述性统计、配对t检验和Pearson相关系数对数据进行分析。
引流前IAP为18.26 mmHg（标准差1.67 mmHg），引流后为14.46 mmHg（标准差1.34 mmHg）（P<0.001）。抽出的腹水平均量为1624 mL（标准差861 mL）。引流后的Cabd为414.01 mL/mmHg（标准差139.15 mL/mmHg）。发现腹水量的减少与IAP变化之间存在线性相关性。引流前呼吸困难VAS评分为7.5（标准差=0.8），引流后为4.3（标准差=1.0）（P<0.001）。
腹腔穿刺放液可降低IAP，从而促进呼吸。此外，IAP变化似乎与抽出的腹水量呈线性关系。IAP与腹水量之间的这种线性关系可能相当准确地预测Cabd，反之亦然。然而，需要更大规模的研究来安全地绘制预测ΔIAP - ΔV（Cabd）图，并确定最佳的腹水量抽出量，以实现患者的最佳舒适度和减缓液体再形成。
