成人腹腔高压和腹腔间隔室综合征诊治中国急诊专家共识(2024)
Emergency expert consensus on diagnosis and treatment of intra-abdominal hypertension and abdominal compartment syndrome in adults in China(2024)
中华医学会急诊医学分会 北京医学会急诊医学分会 北京医师协会急救医学专科医师分会 中国医药卫生文化协会急诊急救分会 谢苗荣 1张国强 2李春盛 1吕传柱3
作者信息
- 1. 首都医科大学附属北京友谊医院急诊科,北京 100050
- 2. 北京中日友好医院急诊科,北京 100029
- 3. 四川省医学科学院·四川省人民医院急诊科,成都 610072
- 折叠
摘要
急诊危重症患者容易合并腹腔高压(IAH)/腹腔间隔室综合征(ACS),且IAH/ACS与不良预后密切相关.目前我国尚缺少急诊危重症患者IAH/ACS诊疗的指导性文件.中华医学会急诊医学分会等多个专业组织在系统梳理近年来相关研究进展,结合急诊科临床工作特点基础上,联合制订了《成人腹腔高压和腹腔间隔室综合征诊治中国急诊专家共识(2024)》,旨在提升急诊医师对成人IAH/ACS的诊疗能力.该共识特别强调了急诊环境中IAH/ACS的早期识别、持续监测和及时治疗的重要性.共识推荐对存在IAH/ACS危险因素的急诊患者进行常规腹腔内压(IAP)测量,并根据IAP水平调整监测频率.治疗方面强调了非手术和手术等综合治疗措施,还特别增加了中医药治疗的推荐.该共识强调了液体复苏、器官功能支持和预防的重要性,提出营养治疗和预防策略.共识为急诊IAH/ACS患者的临床诊疗提供了更为精确和实用的指导,有助于改善患者的临床预后.
Abstract
Patients with emergent conditions are prone to develop intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS),which are closely associated with adverse outcomes.Currently,there is a lack of guiding documents for the management of IAH/ACS in the emergency departments in China.Based on a systematic review of recent researches and clinical experiences in emergency departments,the Emergency Medicine Branch if Chinese Medical Association and other professional organizations have jointly formulated the Emergency expert consensus on diagnosis and treatment of intra-abdominal hypertension and abdominal compartment syndrome in adults in China(2024)to enhance the diagnostic and therapeutic capabilities of emergency physicians regarding adult IAH/ACS.The consensus particularly emphasizes the importance of early identification,continuous monitoring,and timely treatment of IAH/ACS in the emergency settings.The consensus recommends routine intra-abdominal pressure(IAP)measurement for emergency patients with risk factors for IAH/ACS and suggests adjusting the monitoring frequency based on IAP levels.In terms of treatment,the consensus highlights a comprehensive approach that includes both non-surgical and surgical interventions,with additional recommendations for traditional Chinese medicine(TCM)treatments.The consensus also stresses the importance of fluid resuscitation,organ support,and preventive measures,proposing nutritional therapy and preventive strategies.The consensus provides more precise and practical guidance for the clinical diagnosis and treatment of emergency patients with IAH/ACS,which is conducive to improving clinical outcomes.
关键词
腹腔高压/腹腔间隔室综合征/急诊/专家共识Key words
Intra-abdominal hypertension/Abdominal compartment syndrome/Emergency/Expert consensus引用本文复制引用
基金项目
科技部项目(Q20043-2)
国家临床重点专科建设项目(2023)(国卫办医政函[2023]213号)
北京市高层次公共卫生技术人才建设项目(学科带头人-03-015)
出版年
2024
NETL
NSTL
万方数据