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双语推荐：颅内高压综合征

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目的：分析小儿颅内高压综合征的临床治疗。方法：回顾性分析2009年1月-2012年1月在我院治疗的69例小儿颅内高压综合征患者的临床资料。结果：通过积极的治疗，69例患者其中痊愈21例,好转46例,2例因脑疝形成以及严重的并发症治疗无效死亡。结论：应严密观察颅内高压综合征患者病的变化,并给以及时正确的治疗可以降低病死率、致残率。
Objective: to analyze the clinical treatment of children with intracranial hypertension syndrome. Methods: retrospective analysis of 2009 January -2012 year in January in our hospital treatment of 69 cases of pediatric patients with intracranial hypertension syndrome clinical data. Results: the positive treatment, in 69 patients, 21 cases were cured, 46 cases improved, 2 cases with hernia formation and complication in the treatment of severe and death. Conclusion: we should close observation of intracranial hypertension syndrome patients, and to give and correct treatment can reduce the mortality, disability rate.

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近年来,在重症医学界,随着对腹内压关注日益增长,对腹内高压症和腹腔间隙综合征的研究呈现指数增长.积极预防和治疗该综合征对改善危重患者预后非常重要.国内儿科领域对其关注相对较少.本文介绍世界腹腔间隙综合征协会2013年发布的关于腹内高压和腹腔间隙综合征定义共识及临床实践指南的更新中的重点内容,旨在指导儿科医师对腹内高压症和腹腔间隙综合征的诊断、预防和治疗.
Increased attention to intra-abdominal pressure (IAP) have led to an exponential growth in research relating to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in the field of critical care medicine in recent years.Active prevention and therapy of IAH and ACS are important to improve the prognosis of critically illness patients.In domestic pediatric field the attention to IAH and ACS is not enough.This article introduces the main contents of updated consensus definitions and clinical practice guidelines on IAH and ACS from the World Society of the Abdominal Compartment Syndrome.The poppers are to guide the diagnosis,prevention and therapy to IAH and ACS for pediatrician.

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神经肌肉阻滞剂在ICU用于很多疾病的辅助治疗,如急性呼吸窘迫综合征、哮喘持续状态、颅内高压等,重症医学科的医生在使用神经肌肉阻滞剂时要根据循证医学证据及指南合理使用,以减少相关并发症的发生.
Neuromuscular blocking agents have been used for a variety of clinical conditions such as emergency intubation,acute respiratory distress syndrome,status asthmaticus,elevated intracranial pressure,etc.Neuromuscular blocking agents should be used and monitored appropriately according to evidence-based guidelines to reduce the adverse events associated with the use of neuromuscular blocking agents.

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目的：探讨骨盆骨折所致腹腔间隔综合征的诊断与治疗措施。方法：本组骨盆骨折病例162例，其中13例病人诊断为腹内高压IAH。予介入血管栓塞后，仍有5例腹内高压发生腹腔间隔综合征ACS，予急诊手术。下腹部道八字切口，清除血肿，VSD覆盖引流。结果：后腹膜减压手术治疗ACS5例。术后全部病例均恢复。保守治疗8例IAH患者，术后恢复顺利。结论：经后腹膜入路减压是治疗骨盆骨折所致腹腔间隔室综合征的有效方法。
Objective:To discuss diagnosis and treatment of pelvic fractures caused by abdominal compartment syndrome .Methods:162 cases of pelvic fractures at author ’ s hospital from JAN-2007 to APR-2012 .13 patients were diagnosed as IAH ,For the interven-tional therapy of vascular thrombus after ,There were still 5 patients happened ACS,emergency operation.Clearanced of hematoma,Cov-ered drainage by VSD .Results:8 cases IAH with expectant treatment;5 cases of ACS with emergency operation . All recovered smoothly at last.Conclusion: Retroperitoneal approach decompression treatment of pelvic fractures cause by abdominal compartment syndrome might be effective method.

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髌骨倾斜是髌股关节的一种临床影像学表现，在侧位X线片、髌股关节轴位X线片、CT或MRI上都会出现髌骨倾斜的证据，它会使一些患者发生支持带劳损以及髌股外侧高压综合征。髌股外侧高压综合征（excessive lateral pressure syndrome，ELPS）又称为外侧髌骨挤压综合征，是由于髌骨无脱位的长期向外侧倾斜和外侧支持带适应性缩短以及内外侧关节面长期应力不平衡造成外侧髌股关节压力增高而出现的一系列症候群。
Lateral patellar hypertension syndrome is a common clinical disease, but due to different diagnostic criteria, a lot of controversies and difficulties about the diagnosis exist. The anatomical structure of the patellofemoral joint is complex, which can be divided into soft tissue structure and bony structure. The bony structure plays an important role in maintaining the stability of the patellofemoral joint, and the soft tissue structure is mainly composed of medial and lateral patella retinaculum and quadriceps tendon. Patellofemoral pain may be associated with adverse power lines, and abnormal load transmission in the patellofemoral joint and overload in the subchondral bone may be the most important causes of the pain. Pain is the main clinical manifestation of lateral patellar hypertension syndrome, and patellofemoral joint tenderness is mainly included in the physical examination. The quadriceps resistance test results are positive. The X-ray examination shows patellar tilt or sub

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阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见的以间断性低氧、觉醒为特征的呼吸和睡眠紊乱，由呼吸道结构性或神经源性病变导致上呼吸道阻塞而引起，与神经系统疾病息息相关。本文主要探讨OSAS与神经系统疾病，如脑卒中、特发性颅内高压症、癫痫、认知功能障碍、前庭系统功能紊乱、脑静脉血栓形成、自主神经功能紊乱、抑郁焦虑、疼痛、白质病变的关系，以提高我国神经科临床医师对OSAS的重视。
Obstructive sleep apnea syndrome(OSAS) refers toa commonbreathing and sleep disorderduring sleep characterized by consequent decreases in oxygen saturation and arousals from sleep, withrepetitive episodes of either complete (apnea) or partial (hypopnea) obstruction of the upper airway caused by structural abnormality of upper airway ornervous system disease, and is closely correlated tonervous system diseases. This article summarized the associations of OSAS with manynervous system diseases, including stroke,idiopathic intracranial hypertension, seizure, cognitive disorder, vestibular system dysfunction, cerebral venous thrombosis, autonomic nerve dysfunction, depression-anxiety, pain and cerebral white matter diseases, so asto arousethe clinical neurologists to concern andpayattention toOSAS.

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目的 明确逐渐增高的呼气末正压(PEEP)对伴有及不伴有腹腔高压的急性呼吸窘迫综合征患者血流动力学与腹腔压力的影响.方法 对18例入住安徽省立医院重症病房的急性呼吸窘迫综合征患者采用前瞻性对比研究.分别在5、10、15、20 cmH2O呼吸末正压水平通过PICCO测定患者胸腔血容积指数(ITBVI)、血管外肺水指数(EVLWI)以及每博变异率(SVV),同时测定腹内压的变化.结果 (1)高腹内压组EVLWI水平基本随PEEP增加而减少,但15 cmH2O与20 cmH2O之间差异无统计学意义(t=0.593,P=0.572).正常腹内压组患者EVLWI不随PEEP增加而变化.(2)两组患者SVV水平均随PEEP增加而增高,但腹内压正常组SVV在PEEP超过10 cmH2O后差异有统计学意义(PEEP 5 vs.PEEP 10,t=0.326,P=0.752.PEEP 10 vs.PEEP 15,t=-20.032,P＜0.01).(3)两组患者ITBVI在不同呼气末正压水平差异无统计学意义.(4) PEEP能显著增加两组患者的腹内压,对腹内压已经升高的患者影响程度更加明显.结论 PEEP能显著增加ARDS患者的腹内压,对既往已经存在腹内高压的患者,这种效果更加显著;不同PEEP水平能显著降低腹腔高压患者的EVLWI,但对腹内压正常患者影响不显著.
Objective To investigate the effects of positive end-expiratory pressure (PEEP) on hemodynamics and intra-abdominal pressure in patients with acute respiratory distress syndrome (ARDS) with normal intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) during mechanical ventilation under a incremental PEEP.Methods Eighteen ARDS patients with normal IAP or IAH treated in intensive care unit of Anhui Provincial Hospital were enrolled for study.At different PEEP levels (5,10,15,20 cmH2O),hemodynamic parameters including extravascular lung water index (EVLWI),intrathoracic blood volume index (ITBVI),stroke volume variation (SVV) and IAP were measured with PICCO technology.Results Compared with ARDS patients with normal IAP,the ARDS patients with IAH were characterized by:(1) EVLWI was decreasing under the increment of PEEP,but there was no significant difference between 15 cmH2O and 20 cmH2O (t =0.593,P =0.572).As PEEP was gradually escalated,EWLVI had no significan

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门静脉高压症是指由各种原因导致的门静脉系统压力升高所引起的一组临床综合征.门静脉高压症导致的食管胃曲张静脉破裂出血病死率较高.目前针对门静脉高压症食管胃曲张静脉破裂出血的治疗方法很多,包括药物、内镜、经颈静脉肝内门体分流术、分流术、断流术、肝移植等.为进一步合理选择门静脉高压症治疗方法并推广应用,卫生和计划生育委员会卫生公益性行业科研专项“门静脉高压症治疗方法的合理选择和推广应用”专家组,针对门静脉高压症食管胃曲张静脉破裂出血治疗技术规范等相关问题进行充分研讨,并参照国内外有关资料,结合我国具体情况,制订了我国门静脉高压症食管胃曲张静脉破裂出血治疗技术规范专家共识,供广大临床医师参考.
Portal hypertension is a clinical syndrome of elevation of portal vein pressure caused by a variety of reasons,and the mortality of esophagogastric variceal bleeding caused by portal hypertension is still high.At present,there are many treatment methods for portal hypertension with esophagogastric variceal bleeding,including medication,endoscopy,transjugulat intrahepatic portosystemic shunt,bypass and devascularization operation,liver transplantation and et al.In order to further enhance the treatment effect,the treatment technical specifications and other related issues of portal hypertension with esophagogastric variceal bleeding were fully discussed by Experts Group from the Ministry of Health Special Fund for Research in the Public Interest "Reasonable choice and application of treatment of portal hypertension".With reference to the relevant information both at home and abroad,and combined with the specific condition of China,the expert consensus on technical specifications of trea

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近年来,在重症或外伤患者的救治过程中,腹腔内压力(IAP)的重要性越来越得到重视,对腹腔内高压(IAH)及腹腔间隙综合征(ACS)的研究也逐渐增多.2004年世界腹腔间隙综合征协会(The World Society of the Abdominal Compartment Syndrome,WSACS)成立,其专家委员会在2006年提出关于IAH和ACS定义的共识[1],2007年制定临床治疗指南[2],并在2009年提出研究的建议[3],但无论是诊断还是治疗,都主要是针对成人而言.2011年WSACS的第五次国际会议,在回顾文献、更新2006年及2007年诊治指南的基础上,制定的2013版指南特别将ACS诊断标准及治疗方法中的儿童部分单独列出[4],现将儿童部分的内容及其修订的背景进行解读.
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目的：探讨中医平衡理论结合高压氧治疗重型颅脑损伤患者的临床疗效和护理措施。方法：将我院收治的120例重型颅脑损伤的患者随机分为对照组和治疗组各60例，对照组采用常规治疗措施，治疗组在高压氧治疗的基础上结合中医理论，进行辨证护理，同时给予高压氧治疗进舱前、高压氧舱内和出舱后的护理，并对患者进行正确吸氧的健康教育，指导患者进行功能训练。随后比较两组患者治疗的总有效率和住院时间。结果：治疗组的总有效率高于对照组，差异具有统计学意义（P＜0.05），住院时间也较对照组显著缩短（P＜0.01）。结论：中医平衡理论结合高压氧综合治疗与护理重型颅脑损伤患者疗效明显，能够明显降低致残率以及并发症，改善生存质量，对于符合治疗指征的患者应尽早采用。
Objective: To analyze the effect and nursing care of the balance theory of traditional Chinese medical science combining with hyperbaric oxygen treatment for severe craniocerebral injury. Methods: 120 cases of severe craniocerebral injury were randomly divided into control and treatment groups, 60 cases in each group. Patients were given the conventional treat-ment in the control group and the conventional nursing as well as the synthesized nursing based on the balance theory of traditional Chinese medical science, in treatment group, including proper functional exercise, proper sorption oxygen and the healthy education. Then the therapeutic effect of the two groups were analyzed and compared. Results: The cure rate of hy-perbaric oxygen comprehensive group was higher than that of the control group (P<0.05). And the average time staying in the hospital in the hyperbaric oxygen comprehensive group was lower than that of the control group (P<0.01). Conclusion Balance theory of traditiona

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