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Hipertensión intra-abdominal y síndrome abdominal compartamental prevalencia postlaparotomía por abdomen agudo, HVCM Cuenca 2010-2011

Abstract:

The intra-abdominal hypertension (HIA) and the abdominal compartmental syndrome (SCA) they are important cause of postoperative morbid-mortality. Advance in their opportune diagnosis and treatment they have provided better improvement in these patients. Objective: To determine the prevalence of HIA, SCA and to associate it with (surgical discoveries, pressure of Intra-abdominal perfusion (PPI), obesity) intervened by sharp abdomen in the Department of Surgery of the Hospital Vicente Corral Moscoso of Cuenca. Methodology: We was carried out an analytic traverse study in patient bigger than 16 years that need abdominal decompression of September of 2010 until August of 2011 and that they completed exclusion approaches, the PIA was measured by means of indirect method and the information you gathers in a form elaborated for the study. Results: 347 patients were included in the study, the age stocking was located in 46.72 ± 22.30 years, they presented overweight 5.2%, in the pre-surgical stadium we was Intra-abdominal Hypertension in 41.2% and 10.4% of abdominal compartment syndrome; after the abdominal decompression the intra-abdominal hypertension diminished to 37.7% and the syndrome compartmental to 8.4%. The PIA same or bigger at 12mmHg they increase the risk of hiccup-perfusion intestinal in 3.56 times (IC 95%: 1.81-6.99), p <0.05; the obesity behaved as factor of risk with a RP 1.73 (1.451-2.13); the opposing surgical discovery was significant for Abdomen sharp perforation: 2.45 with IC 95% 1.91-3.13; Abdomen sharp hemorrhagic 1.83 with IC 95% 1.46-2.30 and intestinal occlusive sharp Abdomen 2.32 with IC 95% 2.05-2.64. Conclusion: The intra-abdominal Hypertension diminishes progressively in the postoperative one; while in whom the SCA is manifested it remains risen by more time. You evidence that the Obesity influences increasing the PIOUS one, the same one that produces decrease of the PPI pbkp_redicting worse presage; the representative surgical discoveries for the increment of the PIOUS one were the abdomen sharp perforation and occlusive. KEY WORDS: ACUTE ABDOMEN, LAPAROTOMÍA, INTRAABDOMINAL HYPERTENSION.