早期乳酸清除率对严重脓毒症和脓毒性休克预后的影响.pdfVIP

蚌埠医学院学报2016年4 月第41卷第4 期 499 [文章编号]2016 ·临床医学· 早期乳酸清除率对严重脓毒症和脓毒性休克预后的影响 张 亮 [摘要]目的:探讨早期乳酸清除率对严重脓毒症及脓毒性休克预后的影响 方法:收集112例严重脓毒症及脓毒性休克病 例,监测其入院时及入院6h 的乳酸水平,计算乳酸清除率 将患者分为高乳酸清除率(乳酸清除率10%) 组和低乳酸清除 率(乳酸清除率≤10%)组,比较2组病死率 初始乳酸水平和APACHEⅡ评分 随访30d,根据患者生存情况将患者分为存 活组和死亡组,比较2组动脉血乳酸水平 早期乳酸清除率及APACHEⅡ评分 结果:高乳酸清除率组和低乳酸清除率组初 始乳酸水平差异有统计学意义(P 0.01) 高乳酸清除率组病死率和APACHEⅡ评分均明显低于低乳酸清除率组(P 0.01),随访30d后,病死45例,存活67例,存活组APACHEⅡ评分明显低于病死组(P 0.01) 存活组早期乳酸清除率明 显高于病死组(P0.01) 结论:早期乳酸清除率可以作为判断严重脓毒症及脓毒性休克患者预后的一个重要指标 [关键词]脓毒症;乳酸清除率;脓毒性休克 [中图法分类号] R631.2 [文献标志码]A DOI:10.13898/j.cnki.issn2016.04.024 Therelationshipbetweentheearlylactateclearancerate andtheprognosisofpatientswithseveresepsisandsepticshock ZHANGLiang (IntensiveCareUnit,MaanshanPeopleˊsHospital,MaanshanAnhui243000,China) [Abstract] Objective:Todiscusstheeffectsofearlylactateclearancerateontheprognosisofpatientswithseveresepsisandseptic shock.Methods:Thelacticacidlevelsin112patientswithseveresepsisandsepticshockweremeasuredatadmissionandat6hoursof admission,andthelactateclearanceratesofallcaseswerecalculated.Allpatientsweredividedintothehighlactateclearancerate group(thelactateclearanceratemorethan10%)andlowlactateclearancerategroup(thelactateclearanceratelessthan10%).The mortality,initialleveloflacticacidandAPACHEⅡscorebetweentwogroupswerecompared.Allpatientswerefollowedupfor30 days,anddividedintothesurvivalgroupanddeathgroupaccordingtotheirsurvival.Thearterialbloodlactatelevel,earlylactate clearancerateandAPACHEⅡscorebetweentwogroupswerecompared.Results:Thedifferenceoftheinitialleveloflacticacid betweenthehighlactateclearancerategroupandlowlactateclearancerategroupwasstatisticallysignificant(P0.01).Themortality andAPACHEⅡscorei