影響燒傷患者腹內壓之相關因子分析

Analysis of Factors Affecting Intra-Abdominal Pressure in Patients with Burn Injuries

目的：重症燒傷病人由於疾病及各項治療過程之複雜度，容易造成腹內壓（Intra-Abdominal Pressure, IAP）不穩定變化，因此透過IAP監測了解燒傷病人與腹內壓之相關分析。方法：收集某醫學中心2016年3月至2017年2月，共13位入住燒傷加護病房之燒傷病人相關輸液、治療與腹內壓監測，以SPSS for Windows 17.0進行分析，以瞭解燒傷與腹內壓之相關因素。結果：腹內壓與受傷總體表面積（Total Body Surface Area Burns, TBSA）成正相關（r＝0.607，p＜0.05），顯示受傷面積越大腹內壓越大。腹內壓與第一天每小時輸液平均成正相關（r＝0.773，p＜0.01），與第一天尿液輸出平均成負相關（r＝-0.820，p＜0.01）達顯著水準。預防腹內壓之輔助措施包括鎮靜藥物使用、胃減壓及腹腔引流。結論：IAP與TBSA及平均輸液與尿量增減有關，建議燒傷病人應常規監測IAP，以預防腹腔內高血壓的併發症，進而提供優質的燒傷照護。

Purposes Patients with severe burn injuries are prone to unstable changes in intra-abdominal pressure (IAP) due to the complexity of the disease and various treatment processes. Therefore, this study aimed to investigate the correlation between burn injury and IAP. Methods Thirteen patients with burn injuries who were admitted to the burn intensive care unit of a medical center in southern Taiwan between March 2016 and February 2017 were enrolled. The patients were treated and administered related infusions. In addition, their IAP was monitored. The SPSS software for windows 17.0 was used to analyze the correlation between burn injury and IAP. Results IAP was positively correlated with the total body surface area (TBSA) of the burn (r=0.607, p<0.05). In other words, the IAP was higher with larger burn area. On the first day, IAP was positively correlated with the mean hourly infusion (r=0.773, p<0.01) and negatively correlated with the mean urine output (r=-0.820, p<0.01). Ancillary measures to prevent IAP included the use of sedative drugs and gastric decompression and peritoneal drainage. Conclusions IAP is correlated with TBSA assessment and the mean urine output and hourly infusion on the first day. For patients with burn injuries, routine monitoring of IAP to prevent the complication of intra-abdominal hypertension is important to ensure highquality burn care.