Turk J Med Sci. 2019 Apr 18;49(2):506-513. doi: 10.3906/sag-1809-15.
BACKGROUND/AIM: Intraabdominal hypertension (IAH) occurs frequently in patients with acute pancreatitis and adds to their morbidity and mortality. The main aim of the study was to identify the determination of the predictive factors connected to IAH that influence the evolution of acute pancreatitis.
The prospective cohort study was conducted on 100 patients who had acute pancreatitis. According to obtained intraabdominal pressure (IAP) values, the patients were divided into two groups: one group (n = 40) with normal IAP values and the other (IAH group, n = 60) with increased IAP values. Deceased patients were specially analyzed within the IAH group in order to determine mortality predictors.
Statistical significance of IAP (P = 0.048), lactates (P = 0.048), peak pressure (P = 0.043), abdominal perfusion pressure (P = 0.05), and mean arterial pressure (P = 0.041) was greater for deceased than for surviving patients in the IAH group. High mortality appears for patients younger than 65 years old, with lactate level higher than 3.22 mmol/L and filtration gradient (GF) lower than 67 mmHg.
Age, lactates, GF, and APACHE II score are determined as mortality predictors for patients suffering from acute pancreatitis who developed IAH. The mortality rate is higher when the level of GF is decreasing and the level of lactate increasing.
背景/目的：腹腔内高压（IAH）在急性胰腺炎患者中很常见，增加了他们的发病率和死亡率。本研究的主要目的是确定与 IAH 相关的预测因素，这些因素会影响急性胰腺炎的演变。
这项前瞻性队列研究共纳入了 100 名患有急性胰腺炎的患者。根据测得的腹腔内压（IAP）值，将患者分为两组：一组（n = 40）IAP 值正常，另一组（IAH 组，n = 60）IAP 值升高。特别分析了 IAH 组中死亡患者，以确定死亡率的预测因素。
IAH 组中死亡患者的 IAP（P = 0.048）、乳酸（P = 0.048）、峰值压力（P = 0.043）、腹部灌注压（P = 0.05）和平均动脉压（P = 0.041）均显著高于存活患者。IAH 组中年龄小于 65 岁、乳酸水平高于 3.22mmol/L 和滤过梯度（GF）低于 67mmHg 的患者死亡率较高。
年龄、乳酸、GF 和急性生理和慢性健康评估 II 评分（APACHE II score）被确定为发生 IAH 的急性胰腺炎患者的死亡率预测因素。当 GF 水平下降和乳酸水平升高时，死亡率更高。
