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目的:探讨经膀胱腹腔压力(intra-abdominal pressure,IAP)测定在儿外科腹胀患儿中的临床意义。方法:通过对腹胀患儿的IAP测定及简化小儿危重病评估的测评,发现三者的关系,并分析腹腔内高压与补液的关系。结果:56例腹胀患儿中危重者29例占51.8%。其中IAP≥12 mmHg有21例,21例中危重者17例占81.0%。IAP<12 mmHg有35例,35例中危重者12例占34.3%。腹腔高压组与非高压组中的危重者比差异有统计学意义(P<0.05)。29例危重者24 h液体平衡分析,腹腔高压患儿与非高压患儿第1天液体正平衡比无统计学差异,第2、3天液体正平衡比有统计学差异。结论:腹胀患儿IAP不一定都增高,IAP更能反映腹胀患儿的危重情况。准确的IAP测量对病情危重的评估、补液等采取积极的治疗处理及死亡的风险预测均有较大意义,应该受到临床的认识和重视。
Objective: To investigate the clinical significance of intra-abdominal pressure (IAP) measurement in children with pediatric abdominal distension. Methods: The IAP determination of children with abdominal distension and the evaluation of simplified assessment of critical illness in children found that the relationship between the three, and analyze the relationship between intra-abdominal pressure and fluid replacement. Results: Of the 56 children with bloating, 29 were critically ill, accounting for 51.8%. Among them, 21 cases were IAP≥12 mmHg, and 81 cases were moderate-severe in 17 cases, accounting for 81.0%. There were 35 cases of IAP <12 mmHg and 34.3% of 35 cases were critically ill. There were significant differences in the critically ill patients between the high-pressure group and the non-high-pressure group (P <0.05). There was no significant difference in liquid balance between 24 cases of critically ill patients at 24 h and no significant difference in the positive balance of fluid between children with and without high pressure at day 1 and day 2, Conclusion: IAP in children with abdominal distension is not necessarily increased, IAP can better reflect the critical condition of children with bloating. Accurate IAP measurement for the critically ill assessment, rehydration, etc. to take a positive treatment and risk of death are of great significance, should be clinically recognized and valued.