Ali Sheikhi Rahim, Mohammad Heidari, Sara Shahbazi
Department of Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
J Emerg Trauma Shock. 2013 Jul;6(3):176-9. doi: 10.4103/0974-2700.115330.
An increase in abdominal pressure can lead to so-called intra-abdominal compartment syndrome (ACS). Multiple factors such as an increase in retroperitoneal volume due to pancreatitis, bleeding and edema as a result of pelvic fracture can lead to compartment syndrome. Prevention is better than cure in compartment syndrome. By measuring the intra-abdominal pressure (IAP) through the bladder, a quick and accurate assessment of abdominal pressure is achieved. Therefore, this study aimed to evaluate the relationship between pelvic fracture and ACS in traumatic patients.
This research was a descriptive-analytical study conducted on 100 patients referring to the Shiraz Nemazee Hospital in 2010. IAP was monitored every 4 h in patients suspected to be at high risk for ACS, e.g., those undergoing severe abdominal trauma and pelvic fracture. The IAP was measured via the urinary bladder using the procedure described by Kron et al. Data collected were analyzed using SPSS software.
The findings showed that ACS occurred in 28 of 100 patients. With regard to the associated injuries with abdominal trauma, 19% of all patients and 46/42% of the patients with ACS had pelvic fracture. Chi-square test revealed a significant relationship between pelvic fracture and incidence rate of ACS (P < 0.001).
According to the collected data, pelvic fracture due to a trauma can be one of the important causes of an increase in IAP and ACS. In this lethal condition, prevention is better than cure. Therefore, serial measurement of IAP through the bladder in high-risk patients (those with pelvic fracture by trauma) is recommended to the nurses to diagnose this condition and to decrease the incidence of mortality.
腹腔压力升高可导致所谓的腹腔间隔室综合征（ACS）。多种因素，如胰腺炎导致的腹膜后容积增加、骨盆骨折引起的出血和水肿，都可导致间隔室综合征。间隔室综合征预防胜于治疗。通过膀胱测量腹腔内压力（IAP），可快速准确地评估腹腔压力。因此，本研究旨在评估创伤患者骨盆骨折与ACS之间的关系。
本研究为描述性分析研究，于2010年对转诊至设拉子内马齐医院的100例患者进行。对疑似ACS高危患者，如遭受严重腹部创伤和骨盆骨折的患者，每4小时监测一次IAP。采用Kron等人描述的方法通过膀胱测量IAP。收集的数据使用SPSS软件进行分析。
结果显示，100例患者中有28例发生ACS。关于腹部创伤的相关损伤，所有患者中有19%以及ACS患者中有46/42%发生了骨盆骨折。卡方检验显示骨盆骨折与ACS发病率之间存在显著关系（P < 0.001）。
根据收集的数据，创伤导致的骨盆骨折可能是IAP升高和ACS的重要原因之一。在这种致命情况下，预防胜于治疗。因此，建议护士对高危患者（因创伤导致骨盆骨折的患者）通过膀胱进行IAP的连续测量，以诊断这种情况并降低死亡率。
