腹内压变化率在急性肠梗阻患者急性肾损伤中的预测价值
桑云华 谷欣 龙宏杰![](https://cimg.fx361.com/images/2017/03/20/yycy201524yycy20152422-1-l.jpg)
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[摘要] 目的 探讨腹内压变化率在急性肠梗阻患者急性肾损伤中的预测价值。 方法 选取2012年6月~2014年6月广东省惠州市第三人民医院收治的急性肠梗阻患者120例作为观察组,另选取30例同期健康查体者作为对照组。根据腹内压变化率,将观察组又分为A亚组(腹内压变化率>20%,n = 26)、B亚组(腹内压变化率为-20%~20%,n = 53)和C亚组(腹内压变化率<-20%,n = 41)。比较观察组和对照组的平均腹内压及腹内压变化率,检测观察组血肌酐和24 h尿量变化,根据检测结果判断急性肠梗阻患者急性肾损伤的发生情况,采用ROC曲线分析腹内压变化率对性肠梗阻患者急性肾损伤的预测价值。 结果 观察组第1天平均腹内压、第3天平均腹内压和腹内压变化率均显著高于对照组,差异有高度统计学意义(P < 0.01)。与A、B亚组比较,C亚组第1~7天血肌酐均降低,24 h尿量均升高,差异有统计学意义(P < 0.05);与A亚组比较,B亚组第1~7天血肌酐均降低,24 h尿量均升高,差异有统计学意义(P < 0.05)。C亚组急性肾损伤发生率为26.83%,低于A、B亚组的53.85%和39.62%,B亚组急性肾损伤发生率亦低于A亚组,差异有统计学意义(P < 0.05)。腹内压变化率预测急性肠梗阻患者急性肾损伤的ROC曲线下面积、灵敏度、特异度和准确性分别为0.778、94.48%、74.68%和95.26%。 结论 腹内压变化率在急性肠梗阻患者中升高,且对急性肾损伤预测价值良好,对腹内压变化率较高的急性肠梗阻患者,需及时进行肾功能检测,以早期发现或预防急性肾损伤的发生。
[关键词] 腹内压变化率;急性肠梗阻;急性肾损伤;预测价值
[中图分类号] R574.2 [文献标识码] A [文章编号] 1673-7210(2015)08(c)-0094-04
[Abstract] Objective To investigate predictive value on intra-abdominal pressure change rate of acute kidney injury in patients with acute intestinal obstruction. Methods 120 patients with acute intestinal obstruction treated in the Third People′s Hospital of Huizhou City in Guangdong Province from June 2012 to June 2014 were selected as observation group. 30 cases of healthy persons in the same period were selected as control group. Observation group was divided into subgroup A (intra-abdominal pressure change rate > 20% ......
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