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重症监护环境下儿科患者的腹腔内高压/腹腔间隔室综合征

Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings.

作者信息

Marjanovic Vesna G, Budic Ivana Z, Zecevic Maja D, Stevic Marija M, Simic Dusica M

机构信息

Clinic for Anesthesiology and Intensive Therapy, University Clinical Center Nis, Medical Faculty, University of Nis, Nis, Serbia.

Clinic for Pediatric Surgery, Pediatric Orthopedics and Traumatology, University Clinical Center Nis, Medical faculty, University of Nis, Nis, Serbia.

出版信息

Open Med (Wars). 2025 Jul 17;20(1):20251244. doi: 10.1515/med-2025-1244. eCollection 2025.

Abstract

BACKGROUND

Intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) is one of the rarer clinical entities in the pediatric population, carrying a high degree of morbidity and mortality. The focus of this review is on assessing pathophysiological changes of organ systems in pediatric patients with risk factors for the occurrence of IAH/ACS based on the evaluation of diagnostic modalities and therapeutic strategies.

METHODOLOGY

A comprehensive literature search of indexed databases was performed, aiming to identify, review, and evaluate published articles on IAH/ACS. The search was focused on studies examining pathophysiology, risk factors, diagnostic approaches, and management strategies.

RESULTS

The main risk factors encompass diminished abdominal wall compliance, increased intraluminal and abdominal contents, and capillary leak/fluid resuscitation. Diagnostic tools include clinical and imaging findings, intra-abdominal pressure (IAP) monitoring, and parameters of tissue perfusion. Therapeutic strategies involve non-surgical and surgical management of IAH/ACS in pediatric patients.

CONCLUSION

Timely and continuous evaluation of IAP and parameters of tissue perfusion is crucial for the early diagnosis of IAH/ACS and implementing non-surgical procedures, reducing the need for surgical procedures. Future research should focus on the usefulness of advanced non-invasive monitoring technologies and the identification of predictors of increased IAP in the early implementation of personalized therapeutic strategies.

摘要

背景

腹内高压(IAH)/腹腔间隔室综合征(ACS)是儿科人群中较为罕见的临床病症之一,具有较高的发病率和死亡率。本综述的重点是基于对诊断方法和治疗策略的评估,来分析有IAH/ACS发生风险因素的儿科患者器官系统的病理生理变化。

方法

对索引数据库进行全面的文献检索,旨在识别、回顾和评估已发表的关于IAH/ACS的文章。检索重点是研究病理生理学、风险因素、诊断方法和管理策略的研究。

结果

主要风险因素包括腹壁顺应性降低、腔内和腹腔内容物增加以及毛细血管渗漏/液体复苏。诊断工具包括临床和影像学检查结果、腹内压(IAP)监测以及组织灌注参数。治疗策略包括对儿科患者IAH/ACS的非手术和手术管理。

结论

及时且持续地评估IAP和组织灌注参数对于IAH/ACS的早期诊断以及实施非手术程序至关重要,可减少手术需求。未来的研究应聚焦于先进的非侵入性监测技术的实用性以及在早期实施个性化治疗策略时识别IAP升高的预测因素。

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