摘要
目的 初步探讨新生儿腹内压危险值.方法 选择2017年4月至2019年10月昆明市儿童医院普外科收治的腹胀新生儿进行前瞻性研究,根据改良早期预警评分将患儿分为高危组与中低危组,使用受试者工作特征(receiver operating characteristic,ROC)曲线获取腹内压截断值;再根据腹内压截断值将患儿分为腹内压高压组与低压组,比较不同腹内压组患儿一般情况及临床资料.结果 共纳入197例新生儿,高危组45例,中低危组152例,使用ROC曲线获取的新生儿腹内压截断值为5.5 mmHg,根据此截断值将患儿分为高压组58例、低压组139例,与低压组相比,高压组呼吸、心率更快,尿量更少,生命体征不平稳,差异有统计学意义(P＜0.05).结论 建议对腹胀的高危新生儿进行腹内压监测,该人群腹内压危险值为5.5 mmHg.
Abstract
Objective To study the alarming level of intra-abdominal pressure(IAP)in neonates.Methods From April 2017 to October 2019,neonates with abdominal distention admitted to Department of General Surgery of our hospital were prospectively enrolled.They were assigned into high-risk and low/medium-risk groups based on the modified neonatal early warning score.Receiver operating characteristic(ROC)curve analysis was used to determine the cut-off value of alarming IAP level.The patients were further assigned into high-IAP group and low-IAP group according to the cut-off value and their clinical data were compared.Results A total of 197 neonates were included in this study,with 45 in the high-risk group and 152 in the low/medium-risk group.The ROC curve analysis revealed the cut-off value of alarming IAP was 5.5 mmHg.Based on this cut-off value,58 patients were in the high-IAP group and 139 in the low-IAP group.Comparing with the low-IAP group,the high-IAP group showed significantly faster respiration rates and heart rates,decreased urine output and unstable vital signs(all P＜0.05).Conclusions IAP in high-risk neonates with abdominal distension should be monitored,with 5.5 mmHg as the alarming level.
维普
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