Tang Hao, Liu Dong, Guo Yong, Zhang Huayu, Li Yang, Peng Xiaoyu, Wang Yaoli, Jiang Dongpo, Zhang Lianyang, Wang Zhengguo
Wound Trauma Medical Center, State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
Med Devices (Auckl). 2021 Apr 22;14:119-131. doi: 10.2147/MDER.S291407. eCollection 2021.
This study is the largest clinical study of noninvasive Abdominal wall tension (AWT) measurement with a tensiometer to date. It also initially applies a polynomial regression equation to analyze the correlation between AWT measurement and intravesical pressure (IVP) measurement and remarkably finds interesting changes between different IVP intervals and AWT.
Critically ill patients who were treated in the intensive care unit (ICU) of Daping Hospital, Army Medical University, from August 30, 2018, to June 30, 2020, and met the inclusion criteria were prospectively included in this study. The patients were divided into an intra-abdominal hypertension group and a non-intra-abdominal hypertension group and an abdominal infection group and no abdominal infection group. AWT and IVP were measured at 9 points on the abdominal wall on the first day after admission to the ICU. The correlations between AWTs and IVP were analyzed, and the role of AWT in the diagnosis of complications of abdominal infection and the prediction of adverse prognosis were analyzed.
A total of 127 patients were included. The average AWT and IVP were 2.77±0.38 N/mm and 12.31±7.01 mmHg, respectively, on the first day of admission. There was a positive correlation between AWT and IVP (correlation coefficient r = 0.706, < 0.05). The polynomial regression model was AWT= -1.616×10 IVP +8.323×10 IVP+2.094. The cutoff value of the sensitivity and specificity of AWT for the diagnosis of abdominal infection was 2.57 N/mm. Furthermore, AWT = 2.57 N/mm had the best diagnostic efficiency, which was better than that of IAH and lactate.
There was a correlation between AWT and IVP. AWT measurement was helpful in the diagnosis of IAH and abdominal infection complications and can therefore serve as a new method for the clinical diagnosis of IVP and abdominal infection.
本研究是迄今为止使用张力计进行无创腹壁张力（AWT）测量的最大规模临床研究。它还首次应用多项式回归方程来分析AWT测量与膀胱内压（IVP）测量之间的相关性，并显著发现了不同IVP区间与AWT之间有趣的变化。
前瞻性纳入2018年8月30日至2020年6月30日在陆军军医大学大坪医院重症监护病房（ICU）接受治疗且符合纳入标准的重症患者。将患者分为腹腔内高压组和非腹腔内高压组以及腹部感染组和无腹部感染组。在入住ICU后第一天在腹壁的9个点测量AWT和IVP。分析AWT与IVP之间的相关性，并分析AWT在腹部感染并发症诊断及不良预后预测中的作用。
共纳入127例患者。入院第一天平均AWT和IVP分别为2.77±0.38 N/mm和12.31±7.01 mmHg。AWT与IVP之间存在正相关（相关系数r = 0.706，<0.05）。多项式回归模型为AWT = -1.616×10IVP + 8.323×10IVP + 2.094。AWT诊断腹部感染的敏感性和特异性的截断值为2.57 N/mm。此外，AWT = 2.57 N/mm具有最佳诊断效率，优于腹腔内高压（IAH）和乳酸的诊断效率。
AWT与IVP之间存在相关性。AWT测量有助于IAH和腹部感染并发症的诊断，因此可作为IVP和腹部感染临床诊断的新方法。
