乳酸水平及早期乳酸清除率在评估脓毒症预后中应用价值分析.docVIP

乳酸水平及早期乳酸清除率在评估脓毒症预后中的应用价值分析 　　【摘要】 目的：对乳酸水平及早期乳酸清除率在评估脓毒症预后中的应用价值进行探讨分析。方法：选取本院收治的62例脓毒症患者作为研究对象，根据存亡情况将其分为生存组43例和死亡组19例，对两组患者的乳酸水平和早期乳酸清除率进行观察对比。结果：死亡组患者入院时和入院后6 h的血乳酸水平明显高于生存组，6 h乳酸清除率明显低于生存组，高乳酸清除率组患者的APACHEⅡ评分较低乳酸清除率组患者的APACHEⅡ评分低，两组比较差异均有统计学意义（P0.05）。严重脓毒症患者的血乳酸水平和APACHEⅡ之间为正相关（r=0.382，P0.01），6 h乳酸清除率和APACHEⅡ之间为负相关（r=-0.457，P0.01）。6 h乳酸清除率10%患者的死亡率明显高于6 h乳酸清除率≥10%的患者，两组比较差异有统计学意义（P0.01）。结论：乳酸水平和早期乳酸清除率对脓毒症患者预后的评估效果较好。 　　【关键词】 乳酸水平； 早期乳酸清除率； 脓毒症； 预后 　　【Abstract】 Objective：To explore the analysis of lactic acid level and the application value of early lactate clearance rate in the assessment of prognosis of septic.Method：62 patients with sepsis were selected as the research objects according to the survival situation and divided into survival group of 43 cases and death group of 19 cases.The two groups of patients with lactic acid levels and early lactate clearance rate were observed and compared.Result：The death group on admission and after admission blood lactic acid level of 6 h was significantly higher than the survival group，6 h lactate clearance rate was significantly lower than that in the survival group，high lactate clearance group patients with APACHE II score lower lactate clearance rate of APACHE group patients score low，the differences were statistically significant（P0.05）.Sepsis blood lactic acid level and APACHE II was positive correlation （r=0.382，P0.01），between 6 h lactate clearance rate and APACHE II as a negative correlation 　　（r=-0.457，P0.01）.6 h lactate clearance rate of mortality in10% patients was significantly higher than that of 6 h lactate clearance rate greater than 10%，the difference was statistically significant（P0.05）.Conclusion：The assessment of patients with sepsis can use lactic acid levels and early lactate clearance rate for evaluation. 　　【Key words】 Lactic acid level； The early lactate clearance rate； Sepsis； Prognosis 　　脓毒症指的是受到感染因素影响，导致的全身炎症反应综合征。如患者伴有组织灌注不良、器官功能障碍或者低血压等情况，则被称作严重脓毒症，具有高发病率、高死亡率以及医疗费用高的特点，已逐渐成为目前临床医学领域中