Study On The Correlation Between Intra-abdominal Hypertension And Severity And Prognosis Of Severe Acute Pancreatitis

Objective: To investigate the changes of intra-abdominal pressure(IAP)and IAP in patients with severe acute pancreatitis(SAP),and to correlate with severity and prognosis of SAP patients.To provide a theoretical basis for clinical evaluation of the severity and prognosis of SAP patients,and timely intervention according to IAP and its changes,thereby reducing the mortality rate of patients with SAP and improving the prognosis.Methods: We collected 76 patients with SAP in our hospital from October 2016 to December 2018 due to abdominal pain,vomiting,jaundice,shock,etc.After obtaining the consent and signature of the patient and family,all intra-abdominal pressures of patients meeting the study criteria were measured,and the intra-abdominal pressure change rate was calculated for 72 hours.According to the measurement of intra-abdominal pressure,the patients were divided into intra-abdominal hypertension(IAH)group and non-IAH group.The age,sex,height,weight,APACHE II score,Ranson score,CTSI score,SOFA score and intra-abdominal were recorded.Pressure change rate.The ability to predict the mortality of SAP patients was compared by comparing the relationship between the four scoring systems and intra-abdominalpressure,the incidence and prognosis of organ failure,the rate of change in intra-abdominal pressure,and the four-score.Results:(1)According to the intra-abdominal pressure measurement results,60 patients in the IAH group,accounting for 78.9% of the total study,16 patients in the non-IAH group,accounting for 21%.The APACHE II score,Ranson score,CTSI score,SOFA score and intra-abdominal pressure change rate in the IAH group were significantly higher than those in the non-IAH group.The difference between the two groups was statistically significant(P<0.05).(2)The proportion of multiple organ failure(MOF)(43/60)in the IAH group was significantly higher than that in the non-IAH group(2/16),and the difference was statistically significant(P<0.05).Mortality(22/60)was significantly higher in the IAH group than in the non-IAH group(1/16),and the difference was statistically significant(P<0.05)..(3)The predictive value of intra-abdominal pressure change rate for SAP patients(area under ROC curve)was 0.857,which was higher than APACHE II score(0.805),SOFA score(0.759),Ranson score(0.741),and CTSI score(0.716).Conclusion: Intra-abdominal pressure(IAP)and its rate of change can reflect the severity of the disease and its prognosis in SAP patients,and timely intervention according to changes in IAP and IAP,thereby reducing the mortality and prognosis of SAP patients.