【摘要】 目的研究感染性休克患者应用不同输液量晶体液复苏对腹内压的影响。方法前瞻性选取我科2013-03~2014-03间确诊为感染性休克患者37例,按早期目标导向治疗应用晶体液(乳酸钠林格氏液)进行液体复苏。以24 h内复苏液体量的不同,分为A组(60 mL/kg以下)、B组(60~70 mL/kg)、C组(70~80 mL/kg)、D组(80~90 mL/kg)、E组(90 mL/kg以上),分别监测复苏前、复苏24 h后腹腔内压,比较腹内压力变化。结果 5组腹内压均有不同程度升高。复苏后腹内压均值分别为A组:10.3 mmHg;B组:10.6 mmHg;C组:12.4 mmHg;D组:15.8 mmHg;E组:18.8 mmHg。D组和E组与A组相比,P<0.01,有显著差异。结论液体复苏时,腹内压升高程度与输入液体量有关,24 h晶体液输入量70 mL/kg以上会引起腹腔高压,若超过80 mL/kg有导致腹腔间室综合征的高风险。更多还原

【Abstract】 Objective To study the changes of intra- abdominal pressure after fluid resuscitation by different doses of crystalloids solution. Methods Prospectively selecting 37 cases of septic shock requiring the treatment of fluid resuscitation from Mar,2013 to Mar,2014,dividing them into five groups,according to early goal directed fluid therapy to care with lactated ringer’s solution. All patients were divided into A( less than 60 mL /kg),B( 60 ~ 70 mL /kg),C( 70 ~ 80 mL /kg),D( 80 ~ 90 mL /kg) and E( more than 90 mL /kg) groups. Monitoring the intra- abdominal pressure of before and after 24 hours,and doing comparison on the changes of intra- abdominal pressure. Results Five groups of intra- abdominal pressure changes have significant differences. They were 10. 3 mmHg( group A),10. 6 mmHg( group B),12. 4 mmHg( group C),15. 8 mmHg( group D) and 18. 8 mmHg( group E). Different doses of crystalloids solution made significant effects on intra- abdominal pressure in group D and E. Conclusion In fluid resuscitation,the changes of intra- abdominal pressure is related to the input quantity of crystalloids solution in 24 hours. Infusion by more than 70 mL /kg will lead to intra- abdominal hypertersion,and infusion by more than 80mL /kg will lead to the high risk of abdominal compartment syndrome.更多还原