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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)

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ManBetX万博官网地址下载 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。

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abstracts:

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.

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作者: 中华医学会急诊医学分会 北京医学会急诊医学分会 北京ManBetX万博官网地址下载 协会急救医学专科ManBetX万博官网地址下载 分会 中国医药卫生文化协会急诊急救分会
期刊: 《中华危重病急救医学》2024年36卷5期 449-460页 MEDLINEISTICPKUCSCD
栏目名称: 专家共识
DOI: 10.3760/cma.j.cn121430-20240430-00396
发布时间: 2024-07-30
基金项目:
国家科技部项目 2023年国家临床重点专科(急诊医学)建设项目 北京市高层次公共卫生技术人才建设项目 China-Israel Innovation Cooperation Demonstration Project, Ministry of Science and Technology of the People's Republic of China National Key Clinical Specialty Construction Project Beijing High-Level Public Health Technology Talent Construction Project
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