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腹腔内微透析作为重症监护病房的一种监测方法。

Intraperitoneal microdialysis as a monitoring method in the intensive care unit.

作者信息

Konstantinos Tasiopoulos, Apostolos Komnos, Georgios Paraforos, Konstantinos Tepetes

机构信息

1 Homerton University Hospital, London, UK.

出版信息

Int Surg. 2014 Nov-Dec;99(6):729-33. doi: 10.9738/INTSURG-D-13-00139.1.

DOI:10.9738/INTSURG-D-13-00139.1
PMID:25437579
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4254232/
Abstract

Studies on surgical patients provide some evidence of prompt detection of enteric ischemia with microdialysis. The purpose of the study was to measure intraperitoneal microdialysis values (glucose, glycerol, pyruvate, and lactate) in patients hospitalized in an intensive care unit (ICU) with an underlying abdominal surgical condition and to correlate these values with patients' outcomes. Twenty-one patients, 10 female, were enrolled in the study. The intraperitoneal metabolite values were measured for 3 consecutive days, starting from the first day of ICU hospitalization. Descriptive and inferential statistics were performed. The t-test, repeated measures analysis, Holm's test, and a logistic regression model were applied. Level of statistical significance was set at P = 0.05. Mean age of participants was 68.10 ± 8.02 years old. Survivors exhibited statistically significantly higher glucose values on day 3 (6.61 ± 2.01 against 3.67 ± 1.62; P = 0.002). Mean lactate/ pyruvate (L/P) values were above 20 (35.35 ± 27.11). All non-survivors had a mean three day L/P values greater than 25.94. Low L/P values were related to increased survival possibilities. High microdialysis glucose concentration, high L/P ratio and low glucose concentration were the major findings during the first three ICU hospitalization days in non-survivors. Intraperitoneal microdialysis may serve as a useful tool in understanding enteric ischemia pathophysiology.

摘要

针对外科手术患者的研究为利用微透析技术快速检测肠道缺血提供了一些证据。本研究的目的是测量因腹部外科疾病入住重症监护病房(ICU)的患者的腹膜内微透析值(葡萄糖、甘油、丙酮酸和乳酸),并将这些值与患者的预后相关联。21名患者(10名女性)参与了本研究。从入住ICU的第一天开始,连续3天测量腹膜内代谢物值。进行了描述性和推断性统计分析。应用了t检验、重复测量分析、霍尔姆检验和逻辑回归模型。设定统计学显著性水平为P = 0.05。参与者的平均年龄为68.10 ± 8.02岁。幸存者在第3天的葡萄糖值在统计学上显著更高(6.61 ± 2.01对比3.67 ± 1.62;P = 0.002)。平均乳酸/丙酮酸(L/P)值高于20(35.35 ± 27.11)。所有非幸存者的平均3天L/P值大于25.94。低L/P值与生存可能性增加相关。高微透析葡萄糖浓度、高L/P比值和低葡萄糖浓度是在非幸存者入住ICU的前三天中的主要发现。腹膜内微透析可能是理解肠道缺血病理生理学的有用工具。

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本文引用的文献

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Eur J Vasc Endovasc Surg. 2013 Jun;45(6):596-606. doi: 10.1016/j.ejvs.2013.03.002. Epub 2013 Mar 27.
2
Intraluminal intestinal microdialysis detects markers of hypoxia and cell damage in experimental necrotizing enterocolitis.腔内肠微透析检测实验性坏死性小肠结肠炎缺氧和细胞损伤的标志物。
J Pediatr Surg. 2012 Sep;47(9):1646-51. doi: 10.1016/j.jpedsurg.2012.03.086.
3
Intestinal ischemia measured by intraluminal microdialysis.经腔内微透析测量的肠缺血。
Scand J Clin Lab Invest. 2012 Feb;72(1):59-66. doi: 10.3109/00365513.2011.629307. Epub 2011 Nov 21.
4
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Br J Surg. 2012 Jan;99(1):104-11. doi: 10.1002/bjs.7730. Epub 2011 Nov 3.
5
Intraperitoneal microdialysis in the postoperative surveillance after surgery for necrotizing enterocolitis: a preliminary report.经坏死性小肠结肠炎手术后行腹腔内微透析的术后监测:初步报告。
J Pediatr Surg. 2011 Feb;46(2):352-6. doi: 10.1016/j.jpedsurg.2010.11.015.
6
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Scand J Gastroenterol. 2010;45(1):115-21. doi: 10.3109/00365520903386713.
7
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