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目的总结重度以上烧伤患者合并腹腔间隙综合征(abdominal compartment syndrome,ACS)的诊治方法。方法回顾性分析2009年11月2011年6月2例确诊为重度以上烧伤且合并ACS的患儿临床诊治资料,总结烧伤合并ACS的临床诊治方法。结果重度以上烧伤合并ACS的患者可能出现临床表现:心率增快、中心静脉压升高、心输出量降低、低血压、腹胀、呼吸困难、低氧血症和高碳酸血症、少尿或无尿、膀胱压增高等。腹腔减压术后,患儿心率增快、低血压、腹胀、少尿、呼吸困难等症状得到缓解。结论重度及以上烧伤可能合并ACS,烧伤患者中以小儿多见,尚无一致的诊断标准,表现具有一定的隐蔽性、多样化特点,腹腔减压是干预ACS最为有效的治疗措施。
Objective To summarize the diagnosis and treatment of abdominal compartment syndrome (ACS) in patients with severe burns. Methods The clinical data of 2 children diagnosed as having severe burns with ACS were retrospectively analyzed from November 2009 to June 2011. The clinical diagnosis and treatment of burn with ACS were summarized. Results Patients with severe burn and ACS may have clinical manifestations: increased heart rate, increased central venous pressure, decreased cardiac output, hypotension, bloating, dyspnea, hypoxemia and hypercapnia, oliguria or no Urine, bladder pressure increased. After abdominal decompression, children with increased heart rate, hypotension, abdominal distension, oliguria, dyspnea and other symptoms have been alleviated. Conclusions Severe and above burns may be associated with ACS. More common in children with burns, there is no consistent diagnostic criteria. The findings show some characteristics of concealment and diversification. Abdominal decompression is the most effective treatment for ACS.