目的：探讨腹内压变异率与重症胰腺炎病情严重程度和临床预后的关系。方法选取重症胰腺炎患者79例，均每天采用间接膀胱内压测量法监测腹内压（IAP），根据急性生理学与慢性健康状况评分（APACHEII）进行分组，其中APACHEII≥15分（中位值）为观察组40例，APACHEII＜15分为对照组39例，比较2组患者腹内压水平、Ranson评分结果，分析腹内压变异率、APACHEII、Ranson 评分和临床预后的关系。结果观察组腹内压峰值、Ranson评分、器官功能不全发生率和病死率均明显高于对照组（ P ＜0 j．05）；经Pearson相关性分析，腹内压变异率与APACHEII评分、Ranson评分呈明显的正相关（ r ＝0．872，0．718， P ＜0．05），APACHEII与Ranson评分呈明显的正相关（ r ＝0．694， P ＜0．05）；腹内压变异率对病死率预测值（ ROC曲线下面积）为93．65％，稍高于APACHEII评分的89．65％，两者比较差异无统计学意义（ P ＞0．05），而与Ranson评分预测值82．24％比较差异具有统计学意义（ P ＜0．05）。结论腹内压变异率越高，重症胰腺炎病情越严重，且临床预后越差。%Objective To explore the relationship among intra-abdominal pressure variation rate and severe pancreati-tis severity and clinical prognosis .Methods Selected 79 cases of patients with severe pancreatitis , intra-abdominal pressure ( IAP) were measured by indirect monitoring bladder pressure measurement , according to the score of acute physiology and chronic health evaluation (APACHEII), APACHEII ≥15 (median) were defined as the observation group with 40 cases, APACHEII<15 as the control group with 39 cases, intra-abdominal pressure level , Ranson score results were compared be-tween the 2 groups of patients , analyzed the relationship between intra-abdominal pressure variation rate , APACHEII, Ranson score and clinical prognosis .Results Intra-abdominal pressure peak value , Ranson score and organ dysfunction and mortality of observation group were significantly higher than those in the control group ( P <0.05);the Pearson correlation analysis re-vealed that intra-abdominal pressure variation rate was significantly and positively related to APACHEII score and Ranson score ( R =0.872, R =0.718, P <0.05), APACHEII was significantly and positively related to and Ranson score ( R =0.694, P <0.05);intra-abdominal pressure variation rate predictive value for mortality (area under the ROC curve) was 93.65%, slightly higher than the APACHEII score of 89.65%, no statistically significant difference between them were found ( P >0.05), and Ranson score’s predicting value was 82.24%, there were significant difference between intra-abdominal pressure variation rate and Ranson score ( P <0.05).Conclusion Along with intra-abdominal pressure variation rate increased , se-vere pancreatitis is more serious , and the prognosis gets worse .
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