关键词: 腹腔内高压, 腹腔间隙综合征, 肝硬化, 腹水

Abstract: Objective To investigate the efficacy of ascites drainage in treating intra-abdominal hypertension (IAH) under bladder pressure monitoring.Methods From January 2017 to June 2018, 25 patients with liver cirrhosis complicated with IAH in our hospital were enrolled. The abdominal pressure of patients was relieved by ascites drainage under bladder pressure monitoring. Bladder pressure and volume of ascites drainage were detected during treatment. Lactic acid level, acute physiology and chronic health evaluation system II (APACHEII) score and cardiac ejection fraction were detected on admission and 24 hours after admission.Results All the 25 IAH patients were classified into 4 grades according to intra-abdominal pressure, including 9 cases of grade Ⅰ, 7 cases of grade Ⅱ, 6 cases of grade Ⅳ and 3 cases of grade Ⅳ. Bladder pressure decreased significantly when draining 1 000 to 2 000 mL of ascites, then slowed down gradually with more drainage. The average bladder pressure of all the patients was 23.1 cmH₂O on admission, dropped to 8 cmH₂O with an average drainage of 3 350 mL, and increased to 10.9 cmH₂O after 24 hours. After abdominal decompression, lactic acid level, APACHE II score and bladder pressure decreased significantly (P<0.01), while cardiac ejection fraction increased significantly (P<0.01).Conclusion Abdominal decompression by ascites drainage under bladder pressure monitoring can effectively improve tissue perfusion and cardiac ejection function, and prevent the deterioration of disease. This method is convenient, safe and able to be widely used for clinical application.

Key words: Intra-abdominal hypertension, Abdominal compartment syndrome, Liver cirrhosis, Ascites