“动留针术”治疗危重症患者合并腹腔高压的临床观察Clinical Study of “Moving Left Pyonex” for Critical Patients with Intra-abdominal Hypertension
姚瑶,张彦,赵慧,李莉,廖焦鲁,樊艺,王毅刚
摘要(Abstract):
目的观察"动留针术"治疗危重症患者合并腹腔高压的临床疗效。方法选取我院中心ICU的患者76例,随机分为两组各38例。对照组根据WSACS2013版指南中给出的意见,采用常规综合性治疗方式;治疗组在对照组治疗的基础上同时进行"动留针术"治疗。观察患者的膀胱内压、腹腔灌注压、急性生理与慢性健康(APCHEⅡ)评分情况。结果"动留针术"治疗可明显降低腹腔高压患者的膀胱内压,降低患者的腹腔灌注压及APCHEⅡ评分值。结论"动留针术"在治疗危重症患者合并有腹腔高压时,可以缓解患者腹腔高压的情况,减少腹腔间隔室综合征的出现。
关键词(KeyWords): 腹腔高压;动留针术;针刺治疗;ICU;危重症
基金项目(Foundation): 全国名老中医药专家王毅刚传承工作室;; 重庆市科研院所绩效激励引导专项(cstc2018jxjl130080)
作者(Author): 姚瑶,张彦,赵慧,李莉,廖焦鲁,樊艺,王毅刚
参考文献(References):
- [1] Malbrain ML,Cheatham ML,Kirkpatrick A,et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome.I.Definitions[J]. Intens Care Med,2006,32(11):1722-1732.
- [2] Balogh ZJ,Leppaniemi A. The neglected(abdominal)compartment:what is new at the beginning of the 21st century[J].World J Surg,2009(33):1109.
- [3] Andrew WK,Derek JR,Jan DW,et al. Intra-abdominal hypertensionand the abdominal compartment syndrome:updated consesus definitions and clinical practice guidelines from the World Society of theAbdominal Compartment Syndrome[J]. Intensive Care Med,2013,39(7):1190-1206.
- [4] Milanesi R,Caregnato RC. Intra-abdominal pressure:an integrative review[J]. Einstein,2016,14(3):423-430.
- [5] Arabadzhiev GM,Tzaneva VG,Peeva KG. Intra-abdominal hypertension in the ICU-A prospective epidemiological study[J]. Clujul Med,2015,88(2):188-195.
- [6]张连阳.“创伤后腹腔高压症/腹腔间隙综合征诊治规范”解读[J].中华创伤杂志,2012,28(11):965-968.
- [7] Lee RK. Intra-abdominal hypertension and abdominal compartment syndrome:a comprehensive overview[J]. Crit Care Nurse,2012,32(1):19-31.
- [8] Reintam A,Parm P,Kitus R,et al. Primary and secondary intra-abdominal hypertension-different impact on ICU outcome[J]. Intens Care Med,2008,34(9):1624-1631.
- [9]江方正,孙加奎,叶向红,等.腹腔压力测量方法及护理进展[J].解放军护理杂志,2012,29(4):39-42.
- [10] Kural T,Brabec M,Kuda J,et al. The importance of measuring intraabdominal pressure in cases of severe acute pancreatitis[J]. Zentralblatt für Chirurgie,2005,130(2):128-131.
- [11] Chentham ML,Malbrain ML,Kirkpatrick A,et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compatment syndrome.ⅡRecommendaton[J]. Intesive Care Med,2007,33(6):951-962.
- [12]刘冬,张宏光,张连阳.腹腔高压症腹腔高压症/腹腔间隙综合征研究进展[J].灾害医学与救援:电子版,2015,4(3):191-192.
- [13] Vidal MG,Weisser JR,Gonzalez F,et al. Incidence and clinicaleects of intra-abdominal hypertension in critically ill patients[J]. Crit Care Med,2008,36(6):1823-1831.
- [14]田德禄.中医内科学[M].北京:人民卫生出版社,2002:185-186.
- [15]王毅刚.动留针术的临床应用[J].南京中医学院学报,1992,34(2):110-111.
- [16]李延萍.王毅刚针灸临床穴法精要[M].北京:人民卫生出版社,2018:52-59.