关键词: 腹内压, 腹腔灌注压, 体位

Abstract:

Purpose: To observe the effects of body positioning on intra—abdominal hypertension（IAP） and abdominal perfusion pressure（APP）in critically ill patients. Methods: We investigated 78 patients admitted to ICU and measured their IAP from January 2013 to December 2013. IAP was measured with the patient head of bed (HOB) increases from 0°15°,30°to 45°via the bladder. APP were also calculated simultaneously. Results: In the patients of high IAP,Compared with IAP at supine position (bed of head=0°, 16.31 ±3.38 mmHg)， it showed significant difference at 30° (21.46±3.91 mmHg，P=0.001) and 45° (25.69±4.09 mmHg，P<0.001).And APP had significantly decreased at 45°（51.92±10.05mmHg，P=0.03）when compared with that at supine position (60.54 ±9.86 mmHg). In the patients of nomal IAP,Compared with IAP at supine position (bed of head=0°, 7.23±2.14mmHg)， it showed significant difference at 30° (11.17±3.24mmHg，P =0.002) and 45° (15.59±4.13 mmHg，P =0.001).And APP had significantly decreased at 45°（60.78±9.13mmHg，P=0.004） when compared with that at supine position (71.28 ±8.86 mmHg). Conclusion : Body positioning had effects on IAP and APP, IAP significantly increased and APP decreased when the patient's HOB was elevated. The potential contribution of body position in elevating IAP should be considered in critically ill patients.

Key words: Intra abdominal hypertension, Body position, Abdominal perfusion pressure