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急性胰腺炎患者腹腔内高压参数的评估

Evaluation of Intra-Abdominal Hypertension Parameters in Patients with Acute Pancreatitis.

作者信息

Stojanović Maja, Đurić Marko, Nenadić Irina, Dimić Nemanja, Bojić Suzana, Stevanović Predrag

机构信息

Department of Anesthesiology and Intensive Care, University Medical Center "Zvezdara", 11000 Belgrade, Serbia.

Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

Life (Basel). 2023 May 23;13(6):1227. doi: 10.3390/life13061227.

Abstract

BACKGROUND

Patients with acute pancreatitis develop numerous complications and organ damage due to increased intra-abdominal pressure (IAP). These extrapancreatic complications determine the clinical outcome of the disease.

MATERIALS AND METHODS

A total of 100 patients with acute pancreatitis were included in the prospective cohort study. Observed patients were divided into two groups according to their mean values of IAP (normal IAP values and elevated IAP values), which were compared with examined variables. Patients with intra-abdominal hypertension (IAH) were divided into four groups by IAP values, and those groups of patients were also compared with the examined variables.

RESULTS

Differences between body mass index (BMI) ( = 0.001), lactates ( = 0.006), and the Sequential Organ Failure Assessment (SOFA) score ( = 0.001) were statistically significant within all examined IAH groups. Differences between the mean arterial pressure (MAP) ( = 0.012) and filtration gradient (FG) ( < 0.001) were statistically significant between the first and second IAH groups in relation to the fourth. Differences in diuresis per hour ( = 0.022) showed statistical significance in relation to the first and third groups of IAH patients.

CONCLUSIONS

Changes in IAP values lead to changes in basic vital parameters MAP, APP, FG, diuresis per hour, and lactate levels in patients with acute pancreatitis. Early recognition of changes in the SOFA score accompanying an increase in the IAP value is essential.

摘要

背景

急性胰腺炎患者因腹腔内压力(IAP)升高会出现多种并发症和器官损伤。这些胰腺外并发症决定了疾病的临床结局。

材料与方法

前瞻性队列研究共纳入100例急性胰腺炎患者。根据IAP平均值(正常IAP值和升高的IAP值)将观察对象分为两组,并与检查变量进行比较。腹内高压(IAH)患者按IAP值分为四组,这些患者组也与检查变量进行比较。

结果

在所有检查的IAH组中,体重指数(BMI)(P = 0.001)、乳酸(P = 0.006)和序贯器官衰竭评估(SOFA)评分(P = 0.001)之间的差异具有统计学意义。第一和第二IAH组与第四组相比,平均动脉压(MAP)(P = 0.012)和滤过梯度(FG)(P < 0.001)之间的差异具有统计学意义。每小时尿量差异(P = 0.022)在IAH患者的第一组和第三组之间具有统计学意义。

结论

IAP值的变化导致急性胰腺炎患者的基本生命参数MAP、APP、FG、每小时尿量和乳酸水平发生变化。早期识别伴随IAP值升高的SOFA评分变化至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011b/10304430/f9a9ac20a3f6/life-13-01227-g001.jpg

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