失血性低血容量休克预后中血乳酸检测作用.docVIP

失血性低血容量休克预后中血乳酸检测作用 　　[摘要] 目的 观察血乳酸检测在失血性低血容量休克预后评估中的作用。方法 本研究共选取失血性低血容量休克患者23例作为休克组，同时按照休克组治疗的结果分为死亡组和存活组；选取本院同期手术无失血性低血容量患者23例作为对照组，采用酶联免疫法检测各组患者术后0、12、24、48、72h的血乳酸浓度。结果 术后休克组在各时间点的血乳酸浓度明显高于对照组，差异有统计学意义（P＜0.05）。死亡组和存活组比较，死亡组患者各个时间点的血乳酸浓度明显高于存活组。结论 血乳酸检测是一种简单实用的检测指标，在失血性低血容量休克预后评估中有重要的价值。 　　[关键词] 血乳酸；失血性低血容量休克；预后评估 　　[中图分类号] R446.6 [文献标识码] B [文章编号] 1673-9701（2011）23-108-02 　　 　　Blood Lactic Acid Detection in Prognosis Assessment of Hemorrhagic Hypovolemia Shock 　　GAO Shan 　　Department of General Surgery，the First Peoples Hospital of Yuhang District，Hangzhou 311100，China 　　 　　[Abstract] Objective To observe the function of blood lactic acid detection in prognosis assessment of hemorrhagic hypovolemia shock. Methods We selected 23 cases with hemorrhagic hypovolemia shock as shock group in our study，this group was divided into survived group and died group according to the results of treatment；we selected 23 cases without hemorrhagic hypovolemia shock as control group.We detected the blood acid on the 0，12，24，48，72th hour after operation by enzyme linked immunosorbent assay（ELISA）. Results The concentration of blood lactic acid on the every time point after operation in the shock group were higher than that in the control group，they had significant differences（P＜0.05）.The concentration of blood lactic acid on above time in the died group was significantly higher compared that in the survived group（P＜0.05）. Conclusion The detection of blood lactic acid is simple and practical and shows an important value in the prognosis assessment of hemorrhagic hypovolemia shock. 　　[Key words] Blood lactic acid；Hemorrhagic hypovolemia shock；Prognosis assessment 　　 　　失血性低血容量休克是以细胞代谢紊乱及功能受损为主要病理生理改变的综合征，大多数是由创伤及大手术大量失血导致的??效循环血容量减少，组织灌注不足引起的[1]。由于血乳酸可以在失血性低血容量休克患者的常规血流动力学检测指标改变之前反映患者存在的组织低灌注及缺氧状态，所以临床上认为其对失血性低血容量休克患者的血容量减少的敏感性和可靠性均优于氧动力学参数及血液pH[2]，很多学者将血乳酸作为休克复苏效果的最佳观察指标之一[3]。本研究收集我院失血性低血容量休克患者23例，选择同期手术无失血性低血容量临床表现的患者23例，观察血乳酸检测在失血性低血容量休克预后评估中的作用。 　　1 资料与方法 　　1.1 一般资料