腹腔内高血压和腹腔综合征-你需要知道的
Talia R Arcieri1, Jonathan P Meizoso
1From the Divisions of Trauma, Surgical Critical Care, and Burns, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center, Jackson Memorial Hospital, Miami, Florida.
The journal of trauma and acute care surgery
|April 7, 2025
概括
腹腔内高血压是重症患者的严重疾病,可能导致腹腔综合征. 早期监测和逐步管理方法对于预防严重结果和改善患者存活率至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 手术重症监护手术重症监护
- 胃肠病学 胃肠病学
背景情况:
- 腹部高血压 (腹内压力升高) 在重症患者中很常见.
- 它独立地预测了发病率和死亡率,进展到腹腔综合征 (ACS),导致极高的死亡率.
- 病理上升的腹腔内压力导致多系统的生理变化,可能导致患者的快速恶化.
研究的目的:
- 突出识别腹内高血压 (IAH) 高风险患者的重要性.
- 强调需要有效监测和及时治疗IAH和ACS.
- 概述IAH的管理策略,从保守措施到手术减压.
主要方法:
- 高风险患者的临床鉴定.
- 腹内压力监测,特别是每4小时测量一次膀压力.
- 评估腹内压力和器官功能的变化,以指导治疗.
- 应用逐步管理方法,根据需要升级疗法.
主要成果:
- 仅仅身体检查对诊断ACS的敏感性很低.
- 对风险患者来说,监测腹腔内压力是必不可少的.
- 治疗选择取决于压力变化和器官功能障碍的速度和程度.
- 管理包括减少腹腔内体积,增加腹壁服从,并优化液体平衡.
结论:
- 临界护理提供者必须熟练识别需要IAP监测的患者.
- 识别和管理与IAH相关的生理变化至关重要.
- 有效的管理可以防止进展到灾难性的ACS,并改善患者的治疗结果.
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